title: Case of Chlamydia-associated arthritis.
abstract: 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.
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nanke
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobashigawa
authors.forename: Toru
authors.initials: T
authors.lastname: Yago
authors.forename: Naomi
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kamatani
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kotake
mesh_terms: 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
chemical_list: D015235:HLA-B Antigens; D015797:HLA-B35 Antigen; D059947:HLA-B40 Antigen; D010666:Phenylpropionates; C040656:loxoprofen; D017963:Azithromycin