title: Postdysenteric reactive arthritis. A clinical and immunogenetic study following an outbreak of salmonellosis.
abstract: 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)
authors.affiliation: Department of Medicine, University of Toronto, Ontario, Canada.
authors.forename: R D
authors.initials: RD
authors.lastname: Inman
authors.forename: M E
authors.initials: ME
authors.lastname: Johnston
authors.forename: M
authors.initials: M
authors.lastname: Hodge
authors.forename: J
authors.initials: J
authors.lastname: Falk
authors.forename: A
authors.initials: A
authors.lastname: Helewa
mesh_terms: D000328:Adult; D001168:Arthritis / Q000235:genetics; D001170:Arthritis, Infectious / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D016918:Arthritis, Reactive / Q000209:etiology; D002170:Canada; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology; D006680:HLA Antigens / Q000145:classification; D006801:Humans; D007596:Joints / Q000473:pathology / Q000503:physiopathology; D008297:Male; D010146:Pain; D012480:Salmonella Infections / Q000150:complications
chemical_list: D006680:HLA Antigens