Arthritis in Mediterranean spotted fever. An immune complex mediated synovitis.
Arthromyalgia are frequent in Mediterranean spotted fever (MSF) (16-76%) but arthritis is rare. We report on a 54-year-old woman who, 1 day after suffering from fever, headache and malaise, developed a painful and swollen left knee. A maculopapular rash and the characteristic 'tache noire' skin lesion appeared 5 days later. Immune complexes were detected in serum and in the SF and normalized following improvement of clinic manifestations. These findings along with a low C3 complement level in the SF suggest that arthritis was mediated by immune complex deposits.
Aragón
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Rheumatology Unit, Hospital Nuestra Señora del Prado, Talavera de la Reina, Spain.
Cerón
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D000936:Antigen-Antibody Complex / Q000032:analysis / Q000502:physiology*; D001168:Arthritis / Q000150:complications* / Q000276:immunology*; D001907:Boutonneuse Fever / Q000150:complications* / Q000276:immunology*; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008875:Middle Aged; D013582:Synovial Fluid / Q000737:chemistry; D013585:Synovitis / Q000150:complications* / Q000276:immunology*
D000936:Antigen-Antibody Complex; D003176:Complement C3