Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with acute gastroenteritis in whom polyarthritis subsequently developed were found to have positive serologic results for Yersinia pseudotuberculosis. With resolution of the arthropathy the antibody titres decreased. While the patient without the histocompatibility antigen HLA-B27 had an acute, self-limited arthritis, the patient with this antigen had a more chronic arthritis. Serologic typing and stool culture for Y. pseudotuberculosis should be done in cases of postdysenteric arthritis.
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PMID:Postdiarrheal arthropathy of Yersinia pseudotuberculosis. 34 3

Reiter's syndrome is a chronic rheumatic disease that develops after infective urethritis or gastroenteritis and has a strong association with the HLA-B27 antigen. How these factors interact remains unclear. We present a patient with Reiter's syndrome who exhibited 2 novel features: unusually severe urethritis that produced strictures requiring surgery, and dramatic regression of his rheumatic manifestations following a urethrectomy.
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PMID:Decreased activity of Reiter's syndrome after urethrectomy. 236 40

During a five month period in the summer of 1987, seven cases of reactive arthritis were seen at Musgrave Park Hospital, Belfast. Of the seven patients, five were male and two female. Their ages ranged from 13 to 44 (mean: 26 +/- 4) years. Five patients gave a preceding short history of diarrhoea which was usually mild. All patients presented with acute inflammatory oligoarthritis which predominantly affected the lower limbs. The knees were involved in 100%, the ankles in 70% with enthesopathy in 30% of cases. The diagnosis was confirmed in all cases by positive serology for Salmonella enteritidis. In three patients, stool cultures grew a particular strain of Salmonella enteritidis (phage type 4). Six patients were HLA-B27 positive. It is not possible to estimate the prevalence of reactive arthritis in this outbreak because there were different sources of infection and the total number of gastroenteritis cases was unknown. However, gut infections with Salmonella enteritidis are becoming increasingly common in this community and throughout the Western world. Over the past two years, in our area, there has been an almost thirty-fold increase in the number of recorded cases of infections due to this organism. By far the commonest source of infection appears to be poultry and egg products.
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PMID:An outbreak of Salmonella reactive arthritis in Northern Ireland. 269 94

Following an outbreak of foodborne gastroenteritis caused by Salmonella typhimurium, questionnaires were sent to affected individuals and then to the family physicians of any who experienced extra-enteric complications. Of 260 individuals infected with S typhimurium for whom adequate data were obtained, 19 patients developed joint disease (7.3%). All were men; the mean age +/- SD was 39.3 +/- 1.6 years. Among the 16 patients for whom this information was available, the interval from the onset of diarrhea to the onset of joint pain was less than 7 days in 7, 8-21 days in 2, and greater than 21 days in 7. There was a significantly longer duration of diarrhea in those patients with joint disease (mean +/- SEM 15.2 +/- 2.6 days) than in those without complications (10.0 +/- 1.1 days) (P less than 0.01). The joint disease was monarticular in 3 patients and polyarticular in 16. The joints most commonly affected were the elbow (47%), wrist (47%), knee (42%), low back (32%), and shoulder (32%). Six of the 19 patients had at least 1 extraarticular feature: ocular (5 patients), mucosal (1 patient), urethral (2 patients), or cutaneous (1 patient). Of these 19 patients, 11 were located and agreed to HLA typing. Four were positive for HLA-B27, 6 were HLA-B7 positive, and 1 had HLA-Bw60. Of the 4 B27 positive patients, 3 were DR1 positive; of the 6 B7 positive patients, 5 were DR2 positive.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postdysenteric reactive arthritis. A clinical and immunogenetic study following an outbreak of salmonellosis. 319 Jul 82

Serial measurements of serum and secretory antibodies to Salmonella typhimurium were made by ELISA in eight patients with suspected reactive arthritis identified after a large outbreak of Salmonella gastroenteritis. All three patients from whom Salmonella had been isolated developed significant serum IgG, IgA and IgM antibody responses. Only one of the three possessed HLA-B27. A further three patients, two with HLA-B27, had raised antibodies, although none had experienced gastroenteritis. Salmonella infection was not confirmed in the remaining two patients. The three B27-negative patients with confirmed reactive arthritis had HLA-B locus antigens which serologically cross-react with B27. One of six patients with confirmed reactive arthritis was under the age of 25 years whereas 256 of 418 (61%) patients with uncomplicated enteritis were under this age. The development of reactive arthritis may follow subclinical Salmonella infection and is influenced by genetic and age-related factors.
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PMID:Salmonella reactive arthritis: serum and secretory antibodies in eight patients identified after a large outbreak. 394 38

The role of infection in ankylosing spondylitis is speculative and different studies by several groups have yielded conflicting results. The role of infection, however, in reactive arthritis and Reiter's syndrome is well established. The Grampian region has experienced three outbreaks of gastroenteritis, two due to Campylobacter jejuni and one due to Salmonella typhimurium. These outbreaks have allowed a study of reactive arthritis in the affected population following these infections. These studies do not allow accurate estimate of the frequency of reactive arthritis, largely because of difficulties in defining the infected population accurately. They do, however, suggest that in the population milder cases occur than in a population referred to hospital rheumatology clinics. These milder cases have a lower frequency of HLA-B27 than patients seen in a rheumatology clinic and suggest that there may be an association between HLA-B27 and the severity of reactive arthritis. An association between gastroenteritis due to Campylobacter jejuni and Salmonella typhimurium and erythema nodosum both with and without arthritis was observed. No difference was detected in the immunoglobulin responses of immunoglobulins A, G and M between patients with reactive arthritis due to Salmonella typhimurium and patients with gastroenteritis alone.
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PMID:Gram-negative bacteria and B27 disease. 660 75

Reactive arthritis (ReA) is an inflammatory arthritis which follows either chlamydia-induced non-specific urethritis or gastroenteritis due to yersinia, salmonella, shigella or campylobacter. It is distinguished from other infection-induced arthritides by its association with the MHC class I antigen HLA-B27, the pattern of arthritis (a lower-limb oligoarthritis often associated with sacroiliitis) and its systemic features (conjunctivitis, circinate balanitis and skin rash). ReA is unique among inflammatory arthritides in the clear definition of its trigger, its onset, its HLA association, and the demonstrating of a triggering antigen-specific cell-mediated immune response in the joint. Clear delineation of these factors makes it possible to test pathogenetic hypotheses which cannot be analysed in other more common forms of arthritis. However, since there are many similarities between these and ReA, the mechanisms established in ReA may have general relevance in understanding synovitis.
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PMID:Reactive arthritis: a paradigm for inflammatory arthritis. 832 48

Reactive arthritis (ReA) is an inflammatory arthritis triggered by infection, usually urethritis or gastroenteritis, and is strongly associated with the MHC class I antigen HLA-B27. Two recent observations have excited interest: first, antigen and DNA from the triggering bacteria have been identified in the joint and, second, ReA synovial T cells have been found to respond specifically to the bacterium that caused the initiating infection. Because the trigger of ReA, its onset and the MHC association are all clearly defined, we can investigate hypotheses that are impossible to study in other forms of human arthritis. Here, Gabrielle Kingsley and Jochen Sieper review the topic in the light of a recent workshop.
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PMID:Current perspectives in reactive arthritis. 839 77

Yersinia enterocolitica, a gram-negative coccobacillus, comprises a heterogeneous group of bacterial strains recovered from animal and environmental reservoirs. The majority of human pathogenic strains are found among distinct serogroups (e.g. O:3, O:5,27, O:8, O:9) and contain both chromosome- and plasmid (60 to 75 kb)-mediated virulence factors that are absent in "avirulent" strains. While Y. enterocolitica is primarily a gastrointestinal tract pathogen, it may produce extraintestinal infections in hosts with underlying predisposing factors. Postinfection sequelae include arthritis and erythema nodosum, which are seen mainly in Europe among patients with serogroups O:3 and O:9 infection and HLA-B27 antigen. Y. enterocolitica is acquired through the oral route and is epidemiologically linked to porcine sources. Bacteremia is prominent in the setting of immunosuppression or in patients with iron overload or those being treated with desferrioxamine. metastatic foci following bacteremia are common and often involve the liver and spleen. Of particular concern is blood transfusion-related bacteremia. Evidence has accumulated substantiating the role of Y. enterocolitica as a food-borne pathogen that has caused six major outbreaks in the United States. The diagnosis of Y. enterocolitica gastroenteritis is best achieved through isolation of the bacterium on routine or selective bacteriologic media. When necessary, serogrouping, biogrouping, and assessment for plasmid-encoded virulence traits may aid in distinguishing virulent from "avirulent" strains. Epidemiologically, outside of identified food-borne outbreaks, the source (reservoir) of Y. enterocolitica in sporadic cases is speculative. Therefore, prevention and control measures are difficult to institute.
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PMID:Yersinia enterocolitica: the charisma continues. 910 54

Human major histocompatibility complex class I allele HLA-B27 is associated with a group of diseases called spondyloarthropathies. In reactive arthritis (ReA), the disease is triggered by certain infections, e.g. gastroenteritis caused by Salmonella. The host/microbe interaction is abnormal in susceptible individuals leading to inefficient elimination of arthritis-triggering bacteria, fragments of them, or both, after the initial infection. Using transfected human monocytic U937 cell lines, we demonstrate that the expression of the HLA-B27 antigen does not influence the uptake of S. enteritidis into U937 cells in vitro. Interestingly, HLA-B27 remarkably impairs the elimination of S. enteritidis within the HLA-B27 transfected U937 cells. The impaired elimination of ReA-triggering microbes by HLA-B27+ monocytes may offer an explanation for the persistence of ReA-triggering microbes in susceptible HLA-B27+ individuals. This modulation of the host/microbe interaction by HLA-B27 may have an important role in the pathogenesis of ReA.
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PMID:HLA-B27 modulates intracellular survival of Salmonella enteritidis in human monocytic cells. 920 81


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