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衣原体相关性关节炎病例。

Case of Chlamydia-associated arthritis.

作者信息

Nanke Yuki, Kobashigawa Tsuyoshi, Yago Toru, Ichikawa Naomi, Kamatani Naoyuki, Kotake Shigeru

机构信息

Institute of Rheumatology, Tokyo Women's Medical University.

出版信息

Nihon Rinsho Meneki Gakkai Kaishi. 2009 Dec;32(6):511-4. doi: 10.2177/jsci.32.511.

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.

摘要

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。

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