Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:P50583 (asymmetrical)
 12,197 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

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

A case of an acute asymmetrical polyarthritis occurring in a teenage boy is described. This was shown by serological tests to be secondary to a recent infection with Yersinia enterocolitica. Reactive arthritis following infection by this organism is well recognised in Scandinavia. Only recently have two cases been reported in the U.K. (1,2). This is the first reported case in Scotland and is unusual in that the initial infection was asymptomatic. Clinical improvement was associated with falling Y. enterocolitica titres and a reduction in the E.S.R. The patient was HLA B27 positive. It is suggested that all patients presenting with an acute asymmetrical polyarthritis predominantly affecting the lower limbs should be screened by stool culture and serology for recent Y. enterocolitica infection.
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PMID:Reactive arthritis following asymptomatic yersinia infection. 720 6

Reactive spondylarthropathies include mono- or asymmetrical polyarthritis as well as axial skeletal involvement. Usually they occur after urogenital or gastrointestinal infections caused by Yersinia, Salmonella, Shigella or Campylobacter. Reactive arthritis can also result from infections with other agents. We report the case of a patient with clinical features of seronegative spondylarthropathy. The endoscopic examination revealed intestinal spirochetosis. Other possible arthritogenous agents were ruled out serologically. The pathogenicity of intestinal spirochetosis is controversial. It can be associated with diarrhea. In Western countries the prevalence of intestinal spirochetosis is below 2%, male homosexuals being especially prone to these infections. Spirochetosis is often associated with a mild inflammatory reaction only, while a local increase in IgE plasma cell count has been described.
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PMID:[Intestinal spirochetosis and seronegative spondylarthropathy: association or coincidence?]. 767 43

Reactive arthritis, or Reiter's disease, characteristically affects the joints of the lower limbs in an asymmetrical pattern. Usually it does not affect the cervical spine, and atlantoaxial subluxations are the exception. This paper describes the case of an HLA-B27-positive female patient with a sexually acquired reactive arthritis where a non-reducible atlantoaxial subluxation was present. The patient was followed from age 27 to 41. By the age of 38, an anterior decompression of the cervico-medullary junction was performed by a transoral approach; in a second stage, the patient underwent an occipito-cervical posterior fusion. The pathological study revealed a non-specific and chronic inflammatory infiltrate.
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PMID:Reactive arthritis with a severe lesion of the cervical spine. 911 53

Prospective studies of HIV-positive and HIV-negative individuals, longitudinal prospective studies of HIV-positive patients and the African experience with spondyloarthropathies have provided support for a direct role of HIV infection in producing a variety of articular manifestations. The most common manifestations are arthralgia and the spectrum of spondyloarthropathies, but distinct entities such as HIV-associated arthritis and the painful articular syndrome have also been reported. Although initial reports described patients with mainly asymmetric oligoarthritis, a polyarticular presentation is now seen frequently. In Caucasians, HIV-associated reactive arthritis resembles reactive arthritis in non-HIV-infected persons. Reactive arthritis, psoriatic arthritis and undifferentiated spondyloarthropathy were uncommon in Africa and are now detected more often with the HIV epidemic. Although early reports in Western communities reported asymmetrical oligoarthritis as the usual pattern, polyarticular involvement is now seen frequently. Intravenous drug abuse is the most likely risk factor for septic arthritis, even in HIV-infected persons in Western communities, while HIV infection itself may be more important in developing countries where most patients do not receive highly active antiretroviral therapy (HAART). Recent reports have drawn attention to the development of avascular necrosis of the bone in HIV-positive patients and the risk factors include HAART itself, complications of HAART, HIV infection per se or concomitant conventional risk factors. Many patients respond to conventional symptomatic therapy, and disease-modifying drug therapy is necessary for patients who have persistent and progressive arthritis. The use of HAART can modify the prevalence or expression of the articular syndromes.
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PMID:Articular manifestations of human immunodeficiency virus infection. 1278 25

Reactive arthritis or Reiter's syndrome characteristically affects the joint of the lower limb in an asymmetrical pattern. Usually it does not affect the axial skeleton or upper limbs. Although cases of atraumatic atlantoaxial subluxations have been reported, no case of spontaneous sternoclavicular dislocation in Reiter's syndrome has been reported. This paper describes a case of a 26 year old male patient who developed a spontaneous posterior sternoclavicular joint dislocation. No attempt of reduction was made and the patient was managed conservatively with good results.
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PMID:Spontaneous atraumatic dislocation of sternoclavicular joint in Reiter syndrome. 2286 47

Reactive arthritis (ReA) is a member of seronegative spondyloarthropathy (SSA), which involves an acute/subacute onset of asymmetrical lower limb joint inflammation weeks after a genitourinary/gastrointestinal infection. The diagnosis is clinical because it is difficult to culture the microbes from synovial fluid. Arthritis patients with a similar clinical picture but lapsed history of an immediate preceding infection that do not fulfill the diagnostic criteria of other members of SSA, such as ankylosing spondylitis, psoriatic arthritis, and arthritis associated with inflammatory bowel disease, are labeled as peripheral undifferentiated spondyloarthropathy (uSpA). Both ReA and uSpA patients show a strong association with class I major histocompatibility complex allele, HLA-B27, and a clear association with an infectious trigger; however, the disease mechanism is far from clear. Because the clinical picture is largely dominated by rheumatoid-arthritis (RA)-like features including elevated levels of inflammatory markers (such as ESR, CRP, etc.), these overlapping symptoms often confound the clinical diagnosis and represent a clinical dilemma, making treatment choice more generalized. Therefore, there is a compelling need to identify biomarkers that can support the diagnosis of ReA/uSpA. In the present study, we performed NMR-based serum metabolomics analysis and demonstrated that ReA/uSpA patients are clearly distinguishable from controls and further that these patients can also be distinguished from the RA patients based on the metabolic profiles, with high sensitivity and specificity. The discriminatory metabolites were further subjected to area under receiver operating characteristic curve analysis, which led to the identification of four metabolic entities (i.e., valine, leucine, arginine/lysine, and phenylalanine) that could differentiate ReA/uSpA from RA.
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PMID:NMR-Based Serum Metabolomics Revealed Distinctive Metabolic Patterns in Reactive Arthritis Compared with Rheumatoid Arthritis. 3037 45