[Efficacy of cyclines in agammaglobulinemia arthritis].
Five to 40% of patients with agammaglobulineamia develop joint manifestation consisting of septic arthritis or aseptic arthritis of unclear pathogenesis. Intravenous gamma-globulin therapy seems effective on the better condition but is burden-some and expensive. We report the case of a 31-year old woman, having a common variable immunodeficiency that has a chronic oligoarthritis seronegative and not warping. Substitutive treatment with gamma-globulins resulted in a poor improvement. Blood Lymphocyte immunotyping ans analysis of synovial fluid showed high levels of CD8 with a low CD4/CD8 ratio. Synovial biopsy revealed a non specific synovitis with an lymphoid aggregates with a significant predominance of CD8 cells and suspicion of mycoplasm, only after centrifugation, justifying PCR techniques. Doxycycline therapy was effective in relieving the joint symptoms with six month recession.
Kochbati
Samir
S
Service de médecine interne, l'EPS Habib Thameur.
Boussema
Fatma
F
Khamassi
Naziha
N
Ben Dahmane
Fatma
F
Ben Amor
Golsom
G
Ben Rhouma
Samir
S
Cherif
Ouahida
O
Ben Ayed
Mohamed
M
Kastalli
R
R
Rokbani
Lilia
L
D000328:Adult; D000361:Agammaglobulinemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D003241:Consanguinity; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D016130:Immunophenotyping; D016133:Polymerase Chain Reaction; D013582:Synovial Fluid / Q000166:cytology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D016756:Immunoglobulins, Intravenous; D004318:Doxycycline