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)

It has been well established that psoriasis, psoriatic arthritis, and Reiter's syndrome can occur in patients with HIV infection. These arthocutaneous diseases tend to occur in temporal proximity to the development of AIDS and ARC, and their clinical manifestations are unusually severe. The appearance or exacerbation of psoriasis, arthritis, or Reiter's syndrome in a high-risk person should alert the clinician to possible underlying HIV infection. Treatment should be dictated by the severity of the skin and musculoskeletal disease as well as by the status of the immune system. Zidovudine appears to be effective in many diseases, especially psoriasis, and nonsteroidal antiinflammatory drugs are the mainstay for arthritis. Immunosuppressive agents such as methotrexate and azathioprine are contraindicated because they exacerbate immunodeficiency and promote infections. Epidemiologic studies suggest that the prevalence of these diseases, especially Reiter's syndrome, may be higher in HIV-positive populations than previously thought, especially in those patients with AIDS and ARC. Immunogenetic factors like HLA-B27 are important in the predisposition to Reiter's syndrome associated with HIV infection; however, it is not clear what role they play in HIV-associated psoriasis. Mechanisms underlying these observations remain unclear, although potential insights into the pathogeneses of psoriasis and Reiter's syndrome may be gained through future studies. Already it seems likely that CD4-positive helper T-cells, the target of HIV, are not necessary for the expression of psoriasis or Reiter's syndrome, and because of HLA class I associations, a role for CD8 positive cytotoxic T lymphocytes can be suspected. Infections, promoted by the profound immunodeficiency of AIDS, seem to be the most plausible explanations for the cutaneous and articular complications of HIV infection.
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PMID:Psoriasis and psoriatic arthritis associated with human immunodeficiency virus infection. 204 89

The use of intra-articular steroids in one or both knees was evaluated in 21 children with type 1 pauciarticular juvenile chronic arthritis (JCA). The beneficial effect of the injection was noted within 3 days with no significant adverse reactions. Remission exceeding 6 months was seen in 70% of the knees and the arthritis remained inactive during the follow up period in 37%. The beneficial effect of the injection did not correlate with sex, age of onset or the presence of antinuclear antibodies or HLA-B27 antigen and there was no relationship with the size of involved joints at onset, the ESR at onset, or the presence of uveitis. Intra-articular corticosteroids in this type of JCA may provide prompt relief of swelling and pain and reduce the need for other forms of therapy. Remission was long lasting in the majority of the children.
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PMID:Intra-articular steroids in pauciarticular juvenile chronic arthritis, type 1. 204 86

The term reactive arthritis was introduced to describe an acute non-purulent arthritis complicating an infection elsewhere in the body. Reactive arthritis can also be classified into HLA-B27 associated and non-associated forms. Rheumatic fever is an example of the HLA-B27 non-associated forms with genetic factors other than HLA-B27 involved. HLA-B27 associated reactive arthritis includes enteric, urogenic and idiopathic arthritides. The bacteria known to trigger post-enteritic reactive arthritis are: Yersinia, Salmonella, Shigella, Campylobacter, Clostridium difficile and Brucella; those known to trigger post-urethritic reactive arthritis are Chlamydia trachomatis and Ureaplasma urealyticum, but often the germ remains unidentified. Mechanisms through which susceptibility to reactive arthritis is linked to HLA-B27 antigen are still incompletely understood, but a clue could be cross-reactivity between B27 and a surface antigen of pathogenic germs. The clinical profile of the disease is characterized by an asymmetrical oligoarthritis with involvement particularly of the peripheral joints of the lower limbs. The arthritis generally recovers without sequelae within a few weeks or months. Accompanying features can be the involvement of enthesis and tendon sheets in form of a talalgia or dactylitis. In some cases the arthritis can relapse and chronicize. In some cases, in addition, involvement of the axial skeleton can occur (spondylitis and/or sacroiliitis). Another feature of the disease is the frequent association with typical extra-articular manifestations such as uveitis and muco-cutaneous lesions.
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PMID:[Reactive arthritis]. 208 18

The diagnosis of JAS in 19 of the 24 patients with oligo-articular and the polyarticular subtypes of JRA established primarily was reexamined. Coexistence of JAS and rheumatoid arthritis was found in 4 of the 19 patients with JAS. Of the 19 patients with JAS, 18 were male and 1 was female. The mean age of onset of the disease was 12.6 years (ranging from 8 to 16). Peripheral arthritis was the first symptom in all the 19 patients, predominantly in the joints of knee, hip and ankle. 69% of the 13 patients with hip involvement developed deformity. Twelve patients had lumbosacral pain. Arthritis occurred in 7 of the 19. There was X-ray evidence of sacroilitis in all the JAS patients. In 3 of the 19 patients' families, all the family members had ankylosing spondylitis. Laboratory investigations confirmed the presence of HLA-B27 and absence of RF and ANA in these 19 patients. The study shows that early findings of JAS are not easy to distinguish from those of JRA and that the diagnosis of JAS should be considered for a boy of teenage with chronic arthritis.
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PMID:[Juvenile ankylosing spondylitis (JAS) and juvenile rheumatoid arthritis (JRA)]. 209 54

Pathogenesis of seronegative spondyloarthropathies such as ankylosing spondylitis and reactive arthritis is not known. Growing evidence indicates that microbial structures such as Chlamydia antigen and Yersinia antigen are present in the inflamed joints of patients with reactive arthritis. Microbial antigens can activate the host's inflammatory mechanisms. After the activation, the course of inflammation can be postulated to be affected by the host factors responsible for amplification of the inflammatory reaction and elimination of the foreign structures. Thus, the amplification, whether strong, moderate, or weak, may contribute to the degree of inflammatory tissue injury in patients with seronegative spondyloarthropathies. This review will discuss the role of increased inflammatory reactivity in the pathogenesis of HLA-B27 associated spondyloarthropathies, with special reference to reactive arthritis triggered by yersinia enteritis.
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PMID:Enhanced inflammatory reactivity in the pathogenesis of spondyloarthropathies. 210 68

A 19-year-old man with cystic fibrosis developed arthritis at the age of 12 years. He also suffered from psoriasis, and was found to be HLA-B27 positive. His disease was episodic in nature for the first 5 years, but he later developed an unremitting erosive arthropathy which proved difficult to treat.
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PMID:Psoriatic or cystic fibrosis arthropathy? Difficulty with diagnosis and management. 211 8

Rheumatic complaints in a sample of 109 individuals from an isolated community in Papua New Guinea were documented and 92/109 were tissue typed for HLA-B27. Eleven (10.1%) subjects had active peripheral arthritis, but 38 (34.9%) had previously suffered an episode of arthritis. In those with current peripheral arthritis, 6/10 (60%) were HLA-B27 positive compared to 15/58 (25.9%) with no history of arthritis (P less than 0.05). In total, 16/34 (47.1%) with either current or a previous history of peripheral arthritis were HLA-B27 positive compared to the 15/58 (25.9%) with no history of arthritis (P less than 0.05). Back pain was common. In 84/109 individuals the cause was mechanical injury; 24/72 (33.3%) of these were HLA-B27 positive. Ankylosing spondylitis was identified in one HLA-B27-negative woman.
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PMID:HLA-B27, arthritis and spondylitis in an isolated community in Papua New Guinea. 213 24

37 (37%) of 100 patients with anterior uveitis were found HLA-B27 positive (5.3% in the normal controls); 35 (94.6%) of the 37 cases were nongranulomatous and 78.0% were associated with various types of arthritis. T-cell subsets in periphery circulation were evaluated in 47 anterior uveitis patients and 18 controls by means of monoclonal antibodies. Patients with active anterior uveitis had less OKT3+ cells than patients in the inactive phase; there were more OKT4+ and OKT8+ cells in patients in the active phase than in the controls, and particularly the OKT8+ cells were more than in patients of the inactive phase. The mean OKT4+/OKT8+ ratio was not significantly different from that of the controls; however, values of the OKT4+/OKT8+ ratio were abnormal in some patients, and there were more cases with lower ratio values in the active than in the inactive patients.
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PMID:[Studies on HLA-B27 and T-cell subsets in patients with endogenous anterior uveitis]. 215 Aug 1

The association between juvenile arthritis and uveitis is reviewed. Some children with the HLA-B27 related spondyloarthropathies develop anterior uveitis. About 20% of patients with juvenile rheumatoid arthritis (JRA) who are negative for IgM rheumatoid factor develop a frequently bilateral, nongranulomatous chronic anterior uveitis. Risk factors for uveitis in JRA patients are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. Uveitis is rare after seven years or more have elapsed from the onset of arthritis. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop visual impairment from complicated cataract and/or secondary inflammatory glaucoma. The potential benefit of cytotoxic agents in the treatment of intractable uveitis is outweighed by the risk of serious side effects. The management of secondary inflammatory glaucoma is unsatisfactory, but the results of treatment of complicated cataracts by lensectomy-vitrectomy are good.
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PMID:Juvenile arthritis and uveitis. 218 88

We previously reported elevated serum antibody levels to a peptide representing the HLA-B27 polymorphic region (B27 peptide) in HLA-B27(+) ankylosing spondylitis (AS) patients. A plasmid (pHS-2) isolated from arthritogenic Shigella flexneri strains had been shown to encode an amino acid sequence homologous to HLA-B27. Rabbit antibody to this sequence (pHS-2 peptide) strongly cross-reacted with B27 peptide and, to a much lesser extent, with Klebsiella nitrogenase peptide. Serum antibody levels to pHS-2 peptide were studied in 160 spondylarthropathy patients. 12 of 115 (10.4%) AS patients, 2 of 45 (4.4%) patients with Reiter's syndrome or reactive arthritis as well as 6 of 147 (4.1%) normal controls were shown to have elevated anti-pHS-2 peptide antibodies. Antibody levels to B27 and pHS-2 peptides were significantly correlated in 134 HLA-B27(+) patients (r = 0.333, P less than 0.001). 13 of 15 affinity-purified anti-B27 peptide antibodies from patients strongly cross-reacted with pHS-2 peptide, whereas only 3 weakly cross-reacted to nitrogenase peptide. Leucine appeared to be a critical residue for this cross-reaction. AS patients' anti-B27 peptide antibodies reacted with HLA-B27 transfected L cells. These results may suggest that pHS-2 peptide more efficiently "mimics" B27 peptide than does nitrogenase peptide. Involvement of pHS-2 in pathogenesis of spondylarthropathy through molecular mimicry mechanisms requires further study.
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PMID:Autoantibodies to the HLA-B27 sequence cross-react with the hypothetical peptide from the arthritis-associated Shigella plasmid. 221 8


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