A 28-Year-Old Man Comes to the Office with a 2-Month

A 28-year-old man comes to the office with a 2-month history of dull low back pain and morning stiffness.  The pain had an insidious onset, and the patient does not recall any recent trauma.  He attempted treatment with acetaminophen and spinal manipulation, which did not provide relief.  The patient has usually slept on his back but now must lie on his side to fall asleep easily.  Past medical history is unremarkable.  Vital signs are normal.  Physical examination shows limited anterior flexion of the spine.  There is no swelling or warmth of any peripheral joints.  X-rays reveal narrowing of the sacroiliac joints.  Which of the following is most strongly associated with this patient's disease?

A) A specific human leukocyte antigen class I serotype
B) A specific human leukocyte antigen class II serotype
C) Auto-reactive immunoglobulin M antibodies
D) Deficient complement component
E) Selective immunoglobulin deficiency

Correct Answer:

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