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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Certain infections of the genitourinary and gastrointestinal tracts, such as nongonococcal urethritis, dysentery and yersiniosis, precipitate characteristic arthritic syndromes in genetically susceptible individuals. Eye and skin lesions in the form of conjunctivitis, iritis, keratodermia blenorrhagica and erythema nodosum occurring in association with particular distributions of arthritis make recognizable clinical entities. Reiter's syndrome may be diagnosed with certainty from the presence of tender heels, low back pain, a predominance of knee and foot arthritis and pyuria, when the more obvious clinical markers of the syndrome are absent; a flagrant case represents one of the easiest clinical diagnoses in medicine. Diagnosis is important for a good prognosis, optimal treatment and sometimes prophylactic measures. Sacroiliitis often progressing to spinal ankylosis is a prominant feature in the B27-positive patient. Erythema nodosum occurs in B27-negative subjects as a response to yersiniosis and ulcerative colitis.
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PMID:The clinical spectrum of Reiter's syndrome and similar postenteric arthropathies. 15 95

HLA phenotypes were determined in 109 patients with rheumatic fever (RF), 48 patients with Yersinia arthritis (YA), 86 patients with chronic rheumatic heart disease (RHD), and 326 controls. There was an increased frequency of Bw35 in RF as compared to controls (Pc less than 0.01), while B18 was more common in patients with acute carditis than in those without (P less than 0.02). HLA frequencies in RHD did not differ significantly from those in controls. A significant correlation between B27 and YA was observed (Pc less than 0.001). Carditis or iritis occurred in 10 of 31 B27 positive YA patients but in none of 17 B27 negative patients. Eleven of 31 B27 carriers had signs of urological inflammation vs one of 17 B27 negative patients. In the B27 positive YA group, there were three men with previous ankylosing spondylitis and one with Reiter's syndrome (RS). Also, four patients developed RS during Yersinia infection. This simultaneous occurrence of three B27 positive rheumatic diseases suggests that a patient with one "B27 positive rheumatic disease" is more susceptible to other diseases or symptoms known to be associated with the B27 antigen.
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PMID:HLA phenotypes in patients with rheumatic fever, rheumatic heart disease, and Yersinia arthritis. 26 5

The results of crossbreeding experiments between several strains of rats are reported. They show differences in the prevalence of iritis in the course of adjuvant disease as did the results we published in an earlier article. There are alterations which indicate a recessive heredity of the tendency to iritis. The contribution of genetic factors in the course of adjuvant arthritis has been confirmed by the present results.
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PMID:[Genetic differences in the eye-manifestation of adjuvant arthritis in the rat. III. Crossbreeding experiments (author's transl)]. 30 72

Presented in this series were seven men and three women. Ages when seen, ranged from 32 to 68 years (average 54). Psoriasis had begun in childhood in the women and in the late 20's and 30's in the men. Arthritis (ankylosing spondylitis) was present in only one. Their ocular inflammations began from ages 26 to 62 (average 41). The onset of the inflammation was acute iritis in four and in indolent iridocylcitis in six. All but one were bilateral and chronic. The vitreous had heavy debris in nine of the ten patients. The retina was normal in only three. Boggy congestion was present in two with cystoid edema. Patches of edema. fluorescein leaking, depigmentation of both maculae, pars plana exudate, and retinal vessel obliteration to grey-white, shaggy cords was present in at least one of the remaining five patients. Systemic corticosteroid therapy has been used in eight of the ten patients described in this report. Doses no higher than 30 mg of prednisone per day were used to initiate reversal of the inflammatory response. In case 10, knowledge of the sensitivity of the process to steroids led to the successful rapid reversal of a recalcitrant iritis with only 20 mg of prednisone as a first dose and 20 mg per day for less than three weeks. Maintenance corticosteroid therapy ranged from 40 mg of prednisone every other day in case 9, prednisone 12.5 mg one day and 5 mg the next in case 8, to 8 mg of Aristocort or methylprednisolone acetate (M-edrol) daily in cases 1 and 2. In summary, these patients are older, have an indolent onset bilateral uveitis with dense vitreous debris, retinal abnormalites, and are extremely sensitive to systemic corticosteroids. Many of these patients had undergone the series of clinical evaluations known as a "uveitis survey." Many different systemic abnormalities were found and merited treatment which rarely made a difference in their ocular disease, though two improved after infected teeth were treated. Assuming that these ocular diseases were related to psoriasis, one can then challenge the value of anything found by a "uveitis survey." The author uses information gained from such studies to insure that the patient is in the best possible heatlh and then makes clinical correlations such as presented in this paper. The rarity of this combination of ocular inflammations in patients with psoriasis makes it risky to propose that this is a significant association. Arguments that this is a disease entity began with the clinical similarities: older age, indolent onset, vitreous and retinal involvement, and the extreme sensitivity to systemic corticosteroids. None of these patients had psoriatic arthritis and only one had ankylosing spondylitis. The best explanation for the fact that this disorder has not been emphasized in the past would be an attitude of ophthalmologists and physicians that the eye and skin disease were coincident.
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PMID:Psoriasis and intraocular inflammation. 57 84

A study comparing 12 patients with ankylosing spondylitis (AS) to 25 with osteitis condensans ilii (OCI), referred to a rheumatic disease center, was carried out to determine whether OCI represents a varient of AS in women. In the group with OCI, chronic lumbodorsal pain was present in 9, 36%, a 'fibrositis' syndrome in 6, 24%, and 16, 64% had recurrent episodes of polyarthralgia. A definite arthritis with effusion developed in 10 patients, 40%. No patient with OCI had iritis or colitis, whereas 4 patients with AS had iritis and four had colitis. Radiographs of the spine showed no evidence of spondylitis in the OCI group. Of the 25 patients with OCI, only 2, 8% were HLA B27 positive compared with 11 of 12 patients with AS, 92%. These results suggest that OCI is not a variant of AS in women.
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PMID:Comparison of osteitis condensans ilii and ankylosing spondylitis in female patients: clinical, radiological and HLA typing characteristics. 67 May 38

A study of 74 yersinia arthritis patients implied that the clinical picture of the disease may be modified by genetic background associated with the histocompatibility antigen B27 (HLA-B27). Sixty-six percent of patients were B27 positive. Joint symptoms were somewhat more severe in B27+ patients. Iritis, conjunctivitis, carditis, signs of urologic inflammation, and complete Reiter's triad occurred only in the B27 + group, whereas erythema nodosum was more common in B27 - group. Several B27 + patients also had "B27 + rheumatic diseases," such as ankylosing spondylitis or Reiter's disease, in their history.
Arthritis Rheum 1977 Jun
PMID:Relation between HLA-B27 and clinical features in patients with yersinia arthritis. 86 58

A case of Reiter's disease in a 15-month-old child is presented. The manifestation of this syndrome in childhood is an extraordinary event, so far few cases only have been observed. The symptoms of the syndrome are urethritis, arthritis and iritis. A specific infection could not be demonstrated. The typical clinical features are discussed and compared with earlier reports. Speculations on the etiology are made.
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PMID:[Reiter's disease in an infant (author's transl)]. 88 2

Of the many acknowledged systemic complications of inflammatory bowel disease, arthritis, iritis and erythema nodosum are observed most commonly and considered parts of the natural history. Pyoderma gangrenosum is a more ominous, less common but similarly associated complication that classically occurs in the course of ulcerative colitis. Its rarity in Crohn's disease stimulated the following report.
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PMID:Pyoderma gangrenosum complicating Crohn's disease. 92 Jul 18

Reactive arthritis following infection with Yersinia is endemic in Scandinavian countries; the prevalence is low in the UK, however. We have reviewed the literature pertaining to Yersinia-related reactive arthritis in the UK and describe 12 patients who presented over a 3-year period with an asymmetrical seronegative polyarthropathy and serological evidence of recent Yersinia infection. Five patients recalled having a diarrhoeal illness prior to the onset of the arthropathy. None had a prior history of psoriasis, inflammatory bowel disease or ankylosing spondylitis. A history of urethral discharge was elicited from one patient. Extra-articular manifestations were seen in three patients (iritis in two, erythema nodosum in another). Four patients developed chronic joint disease after periods of 4, 6, 8, and 18 months, respectively. The prevalence of Yersinia-related arthritis in the UK may be higher than previously thought.
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PMID:Yersinia-related arthritis in the United Kingdom. A report of 12 cases and review of the literature. 148 36

A 25-year-old patient presented at 14 weeks of her 3rd pregnancy with chondritis affecting the cartilaginous portion of her right ear. The clinical syndrome of recurrent chondritis, scleritis, iritis and arthritis supported a diagnosis of relapsing polychondritis. Fetal and maternal outcomes were favorable despite steroid dependent active disease during the period of fetal organogenesis. Chondritis was limited to the 3rd pregnancy, ocular inflammation occurring in the 2nd and 3rd pregnancies. A 4th pregnancy was uneventful. This may represent the first case of relapsing polychondritis in pregnancy.
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PMID:Relapsing polychondritis in pregnancy. 227 97


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