Case of Chlamydia-associated arthritis.
We report a case of Chlamydia-associated arthritis in a 40-year-old man. The patient experienced four episodes of Chlamydia trachomatis urtethritis within a few years. During the present episode, polyarthritis developed a few days after Chlamydia trachomatis urethritis was noted. The patient was diagnosed as having Chlamydia-associated arthritis. Loxoprofen sodium and azithromycin were started. Antibiotics induced clinical improvement of urethritis, although arthritis persisted for 3 months. HLA-B27 was negative, but both HLA-B35 and B40 were positive. Thus, we speculate that positivity for both HLA-B35 and HLA-B40 contributed to the persistence of arthritis in this case. During the course, the levels of Th1, Th17 and regulatory T cells in the peripheral blood were increased on flowcytometry. Thus, we speculate that Th17 may play, at least in part, an important role of the pathogenesis in this case.
Nanke
Yuki
Y
Institute of Rheumatology, Tokyo Women's Medical University.
Kobashigawa
Tsuyoshi
T
Yago
Toru
T
Ichikawa
Naomi
N
Kamatani
Naoyuki
N
Kotake
Shigeru
S
D000328:Adult; D001170:Arthritis, Infectious / Q000209:etiology / Q000276:immunology; D017963:Azithromycin / Q000627:therapeutic use; D002690:Chlamydia Infections; D002692:Chlamydia trachomatis; D004359:Drug Therapy, Combination; D015235:HLA-B Antigens; D015797:HLA-B35 Antigen; D059947:HLA-B40 Antigen; D006801:Humans; D008297:Male; D010666:Phenylpropionates / Q000627:therapeutic use; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D016896:Treatment Outcome; D014526:Urethritis / Q000150:complications / Q000188:drug therapy
D015235:HLA-B Antigens; D015797:HLA-B35 Antigen; D059947:HLA-B40 Antigen; D010666:Phenylpropionates; C040656:loxoprofen; D017963:Azithromycin