Ankylosing Spondylitis, Hyperuricemia, and Anomalies of the Lumbosacral Junction

Abstract
Genetic factors are important in ankylosing spondylitis, hyperuricemia, and gout, because to our knowledge there are no reports of these illnesses occurring in the same patient. It is pertinent to report a family with hyperuricemia and gout, ankylosing spondylitis, and various developmental anomalies of the lower spine occurring in several members of 3 generations. The propositus, a 44-year-old man, had tophaceous gout, ankylosing spondylitis, and a transitional lumbosacral vertebra with spine bifids. Of his 8 children, 2 had ankylosing spondylitis, one of whom also had hyperuricemia; 3 other children had various developmental anomalies of the lumbo-sacral spine. The 3 brothers of the propositus all had hyperuricemia; 2 of whom had gouty arthritis. Furthermore, 2 of the 3 brothers had radiographic findings which suggested ankylosing spondylitis. The mother of the propositus had hyperuricemia and osteitis condensane flei. One maternal uncle had far advanced ankylosing spondylitis, and another had hyperuricemia. Several paternal aunts and uncles had hyperuricemia, and a paternal uncle demonstrated the typical transitional appearance at the lumbosacral junction seen in this family. This pedigree supports the concept that both ankylosing spondylitis and hyperuricemia are inherited traits; the former being carried through the propositus''s mother; the latter through both sides of the family. It is of interest that gouty arthritis occurred only in the propositus and his siblings.