Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a 24-year-old man who developed reactive arthritis (ReA) after a dysenteric illness caused by Salmonella hadar. Serologic tests suggested recent exposure of family members to Salmonella. All members of the family were HLA-B27 positive, but no other family member developed acute ReA, although 2 of them had clinical evidence of previously existing B27 associated arthritis.
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PMID:Interplay of microbe and major histocompatibility complex: a family study. 178 3

One hundred and fourteen patients with acute anterior uveitis were studied for the presence of the HLA-B27 tissue type, the prevalence of spondylitis and arthritis and the occurrence of gastro-intestinal and urogenital infections or diarrhoeal illness in the history. Eighty-seven (76%) were B27+ and 27 (24%) B27-. Forty-two (48%) of the B27+ group had ankylosing spondylitis (AS); 13 (30%) of them were females. Sacroilitis (SI) with no spinal involvement was present in 21 patients (24%), 13 (61%) males and 8 (38%) females. Peripheral arthritis occurred in 6 patients. Thus, 68 (78%) of the HLA-B27+ positive patients had inflammatory spinal and/or joint disease, compared with 1 (4%) of the HLA-B27- group (p less than 0.001). The AS diagnosis was unknown previous to our examination in 31% of the males and 54% of the females, and SI was undiscovered in 61% of the males and 62% of the females. The occurrence of acute enteric infections was significantly increased in the B27+ AAU group, compared with the B27- patients and the patients reported exacerbation of AAU in connection with episodes of diarrhoea. An increased occurrence of urogenital infections was shown only in co-comparison with the males of the B-27+ AAU group. Thirty-three out of 47 AAU patients assayed by enzyme immuno-assay (EIA) for the quantification of IgM, IgA and IgG antibodies against Klebsiella pneumoniae, E coli, and Proteus mirabilis had significantly raised antibody titres against one or more of the antibodies studied, as compared to 62 healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute anterior uveitis, arthritides and enteric antigens. 180 94

We carried out a prospective study of the clinical, laboratory and radiological features of 180 patients with psoriatic arthritis. We initially classified our patients into five groups as described in the publications of Moll and Wright. Thirty-seven per cent had oligoarthritis, 36% polyarthritis, 23% spondarthritis (sacroiliitis and/or spondylitis) and 4% had the mutilans form. The distal joint arthritis type did not exist as an entity and the distal interphalangeal (DIP) joints were affected in all groups. The spondarthritis form includes patients with exclusively axial manifestations and also those who in addition have peripheral arthritis (oligoarthritis, polyarthritis, DIP arthritis). Only 53% of our patients had nail involvement. We found an increase of IgA levels in patients with axial disease. This suggests a relationship between ankylosing spondylitis and psoriatic spondylitis. The HLA-B17/Cw6 association increased in the oligoarticular form. The increase of antigen B17 correlated with the spondarthritic and oligoarthritis forms whereas Cw6 was more important in the oligoarthritis form. An increase of the HLA-B27/Cw1 association and the spondarthritic form was also found. Moreover, we detected a greater incidence of the HLA-B27 antigen in patients with bilateral sacroiliitis (85%) than in patients with unilateral sacroiliitis (22%). Our work revealed that PA is not a harmless disease; 57% of our patients had erosive arthritis while 19% had ARA class III or IV functional impairment.
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PMID:Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients. 154 Jul 94

Because one of the spondyloarthropathies, reactive arthritis, is induced by infections, research into the role of arthritis-causing bacteria has been strongly emphasized. The most remarkable finding in recent years is the detection of some of the bacterial components in the articular compartment, in some cases even several years after the development of arthritis. This location would account for the fact that T lymphocytes in the synovial compartment demonstrate a high in vitro response to preparations of the arthritis-causing bacteria. The persistence of these bacterial components would explain the frequently reported prolonged antibacterial antibody response in arthritis patients. Although the factors leading to the location and persistence of the bacteria are not clear, the finding provides a rationale for treating these patients with long-term antibiotics. A major question being investigated is how the presence of bacterial components in the articular compartment is related to the predominance of HLA-B27 in many of the patients.
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PMID:Infectious agents and other nongenetic immunologic factors in spondyloarthropathies. 191 Oct 53

A 12-year-old female (HLA-B27 negative) presented with unilateral low back pain and sterno-clavicular arthritis. Six months after onset the clinical and radiological findings determined spondylodiscitis L1/2. On the basis of the clinical findings (oligoarthritis, symptomatic sacroilitis, spondylodiscitis), juvenile ankylosing spondylitis was suspected. The diagnosis was corroborated 18 months after the first occurrence of symptoms by the appearance of typical changes in the sacroiliac joint that are indicative of juvenile ankylosing spondylitis. Because of persisting antibodies against Borrelia burgdorferi, the possibility of B. burgdorferi-induced reactive arthritis with involvement of the axial division of the skeletal system was considered. After 3.5 years of observation the condition showed a benign course with radiologically observable consolidation of the spondylodiscitis. To our knowledge, this is the second case described of juvenile ankylosing spondylitis with spondylodiscitis as a dominating feature.
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PMID:[Spondylodiscitis as a dominant early symptom of juvenile ankylosing spondylitis]. 192 65

The influence of HLA-B27 antigen on clinical, radiological and laboratory features of rheumatoid arthritis (RA) was studied. The group with B27 antigen comprised: 4 males and 20 females aged 28 to 71 and a group of patients free from B27 antigen consisted of 2 males and 21 females aged 26 to 69. RA patients possessing the B27 antigen did not differ regarding the age of the onset of disease, the distribution of affected joints during the follow-up (3-10 years), the development stages of the disease and the presence of rheumatoid factor when compared with B27 negative RA patients. The arthritis of the radiocarpal joints (p less than 0.01) was significantly more often the first sign of the disease in patients with B27 antigen. In these patients low back pain and morning stiffness in the low back were twice as frequent as they were in patients not possessing this antigen. The clinical pattern of the affected spine was also found more frequently in B27 carriers (p less than 0.05). B27 positive RA patients showed also the clinical pattern of sacroiliitis (SI) (p less than 0.05) and x-ray SI (p less than 0.01) significantly more often than the patients free from this antigen. In addition, symmetric arthritis of the peripheral joints was more often diagnosed in patients free from B27 antigen.
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PMID:HLA-B27 antigen and rheumatoid arthritis. 195 Jun 38

The Second International Simmons Center Conference on HLA-B27-Related Disorders presented a number of new observations related to the molecular biology of the HLA-B27 molecule, its functional biology as a peptide-binding molecule, and the clinical implications of the association of B27 with the spondylarthropathies, as well as new clinical information concerning these diseases. As a result of the rapid developments in these fields, new insights into the pathogenesis of the B27-related spondylarthropathies will emerge.
Arthritis Rheum 1991 Nov
PMID:The Second International Simmons Center Conference on HLA-B27-Related Disorders. 159 28

On basis of clinical and immunogenetic factors most children with pauciarticular juvenile chronic arthritis can be included in one of the subtypes: type 1 and type 2 pauciarticular JCA. Type 1 occurs in young children, mainly girls, with involvement of knees, ankles or elbows. In the majority of children antinuclear antibodies can be detected. The presence of these autoantibodies is associated with chronic anterior uveitis. Type 2 or the juvenile spondylarthropathies include morbus Bechterew, the reactive arthritides and arthritis associated with psoriasis and inflammatory bowel diseases. Large joints of the lower extremities are involved, back pain is unusual at onset, but enthesitis is frequently present. There is a strong association with HLA-B27. Treatment of both subsets consists of non-steroidal anti-inflammatory drugs, application of intra-articular steroids, physio- and hydrotherapy and splinting. In children with a polyarticular course of type 1, or a prolonged course of type 2 disease modifying drugs are often needed.
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PMID:[Pauciarticular juvenile chronic arthritis]. 195 1

The passive intestinal permeability of patients with yersinia triggered reactive arthritis was studied using different sized polyethylene glycols (PEGs) contained in a mixture of PEG 400 and PEG 1000. The investigation was carried out at least one year after the onset of yersinia infection, and patients had neither acute gastrointestinal nor joint symptoms. The control groups included patients with uncomplicated yersiniosis as well as healthy subjects who were either HLA-B27 positive or negative. An altered intestinal barrier function to PEG molecules was detected in patients with a history of yersinia infection compared with healthy controls. No significant differences in the permeability were found between patients with or without reactive arthritis, nor was there any association of increased permeability with HLA-B27. The passive permeability of the intestinal mucosa to the larger molecules was increased for an unexpectedly long time after the acute yersinia infection, probably contributing to the perpetuation of joint symptoms in subjects susceptible to a chronic joint disease.
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PMID:Intestinal permeability in patients with yersinia triggered reactive arthritis. 199 97

Several distinct arthritic syndromes now have been recognized in HIV-infected persons. These comprise seronegative spondarthritis, including classic Reiter's syndrome and psoriatic arthritis associated with HLA-B27, and undifferentiated arthritis usually confined to the lower limbs, unassociated with other lesions, and unrelated to any known genetic marker. In such cases great care should be taken to exclude infection. In addition, a syndrome of short-lived but sometimes severe arthralgias also occurs. Spinal pain is a major problem in some patients but ankylosing spondylitis appears to be rare among this group. Psoriasis probably occurs more often in the HIV-infected group than in the population in general and may be especially severe in those patients with arthritis. Arthritis has been reported in the United States, Europe, and Africa among persons considered to be at high and low risk for HIV infection. Arthritis can occur at any stage of HIV infection, but the true prevalence of arthritic syndromes and the nature of their association with HIV infection remains unclear. In view of the development of Reiter's syndrome in some patients, precipitating bacterial infections have been sought as the culprits. In a minority of cases, shigella, yersinia, and campylobacter infections have been implicated, but in the majority of cases, no specific infection has been identified. In most patients depletion of circulating CD4-positive lymphocytes is present by the time that arthritis is detected, but only limited data on synovial immunopathology are available. In some patients changes of nonspecific chronic synovial inflammation are present and synovial fluid cell counts are high. In other patients evidence of inflammatory changes is minimal. Human immunodeficiency virus has been isolated from joint fluid and identified in large mononuclear, probably dendritic, cells and lymphocytes. Synovium from patients dying with AIDS but with apparently normal joints also shows significant abnormalities that could lead to joint disease in long-term survivors. The possibility of a viral etiology of arthritis in some cases is suggested by the induction of arthritis in animals by lentivirus infection; it also is possible, however, that HIV enhances the effect of mechanisms that can operate in the absence of HIV infection. Conventional treatments of rheumatic lesions, including intraarticular steroids, appear to be safe and reasonably effective. Anecdotal evidence suggests that treatment with methotrexate and azathioprine leads to exacerbation of HIV disease and should be avoided.
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PMID:Reiter's syndrome and associated arthritides. 204 87


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