This is a case report linking yesterday's posts on Spinal Stenosis to today's on Psoriasis. It's a reminder to doctors to consider Abdominal Aortic Aneurysm (AAA) as a differential to Spinal Stenosis especially in elderly patients presenting with lower back pain and leg claudication symptoms (pain, numbness, weakness). Both conditions can co-exist.
Of all the reported associations with Psoriasis and/or Psoriatic Arthritis, the most important is with the Metabolic Syndrome (obesity, hypertension, dyslipidaemia, diabetes mellitus, gout, cardiovascular disease). This latest metaanalysis of various earlier studies puts the link quite beyond doubt, especially in those with more severe Psoriasis.
This review from 2008 already suggested that the underlying pathophysiology linking Psoriasis with the Metabolic Syndrome is Inflammation:
The Inflammation theme is recapitulated and explored further in this more recent 2015 article:
dovepress.com|By Dove Press
Possible mechanisms for this association include hyperuricaemia and atheromatous renal arterial disease.
The obvious link between Psoriasis and Obstructive Sleep Apnoea is through the Metabolic Syndrome: obesity; not so much as one condition causing the other.
Another study posted some time back drew the link between Gout and Sleep Apnoea.
Here, it is difficult to explain how one may cause the other. Again, the association may be through the Metabolic Syndrome, Obesity and Inflammation.
Danish researchers studied a cohort of 59,423 mild psoriasis and 11,566 severe psoriasis patients over a 14 year period, and found 240 and 50 cases of abdominal aortic aneurysms (AAA), repectively. (Citation source http://buff.ly/1YxGpDA) rheumnow.com
I'll wrap up today's posts on Psoriasis associations with what I began with: Abdominal Aorta Aneurysm. The mechanism of the link is plausibly accelerated atherosclerosis, through the inflammatory Metabolic Syndrome.