Tonsillitis linked to increased risk for ankylosing spondylitis

  • Chao WC & al.
  • PLoS ONE
  • 1 Jan 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Patients with tonsillitis are at an increased risk of developing ankylosing spondylitis (AS).
  • The association between tonsillitis and AS is stronger in patients with higher severity of tonsillitis or a longer interval between AS and diagnosis of tonsillitis.

Why this matters

  • Findings suggest that tonsillitis may trigger a gradual exacerbation of inflammation in patients with AS.

Study design

  • This population-based case-control study included 37,002 newly diagnosed AS patients and 222,012 age-, sex- and index year-matched (1:6) non-AS controls.
  • Funding: Taichung Veterans General Hospital, Taiwan.

Key results

  • Patients with AS vs non-AS controls were more likely to have:
    • tonsillitis (45.5% vs 36.2%; aOR, 1.46; 95% CI, 1.43-1.50; P<.001>
    • appendicitis (0.7% vs 0.5%; aOR, 1.29; 95% CI, 1.13-1.48; P<.001 and>
    • periodontitis (29.0% vs 22.8%; aOR, 1.35; 95% CI, 1.31-1.38; P<.001>
  • AS in female patients had significantly higher association with tonsillitis than in male patients (aOR, 1.59; 95% CI, 1.53-1.65 vs aOR, 1.39; 95% CI, 1.35-1.44).
  • AS risk was highest among those with:
    • >4 visits for tonsillitis (aOR, 1.82; 95% CI, 1.75-1.89), and
    • ≥5.4 years interval between tonsillitis and AS (aOR, 1.84; 95% CI, 1.76-1.91).

Limitations

  • Causal link between tonsillitis and newly diagnosed AS could not be determined.
  • Clinical severity of tonsillitis was not assessed.