Nanke Yuki, Kobashigawa Tsuyoshi, Yago Toru, Ichikawa Naomi, Kamatani Naoyuki, Kotake Shigeru
Institute of Rheumatology, Tokyo Women's Medical University.
Nihon Rinsho Meneki Gakkai Kaishi. 2009 Dec;32(6):511-4. doi: 10.2177/jsci.32.511.
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.
我们报告一例40岁男性衣原体相关性关节炎病例。该患者在几年内经历了4次沙眼衣原体尿道炎发作。在本次发作期间,在发现沙眼衣原体尿道炎几天后出现了多关节炎。该患者被诊断为衣原体相关性关节炎。开始使用洛索洛芬钠和阿奇霉素治疗。抗生素使尿道炎临床症状改善,尽管关节炎持续了3个月。HLA - B27为阴性,但HLA - B35和B40均为阳性。因此,我们推测HLA - B35和HLA - B40阳性促成了该病例中关节炎的持续存在。在此过程中,流式细胞术检测显示外周血中Th1、Th17和调节性T细胞水平升高。因此,我们推测Th17可能至少在一定程度上在该病例的发病机制中起重要作用。