Khaidarova Yulduz, Kurmanova Gaukhar, Nurgaliyeva Gulzada, Omarova Madina
Department of Clinical Disciplines, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
City Rheumatology Center, Almaty, Kazakhstan.
Med J Islam Repub Iran. 2024 Aug 5;38:89. doi: 10.47176/mjiri.38.89. eCollection 2024.
High titers of specific antibodies to cyclic citrulline peptide (ACCP) are often present in the serum of patients with rheumatoid arthritis (RA) and, together with rheumatoid factor (RF), are a diagnostic marker of RA. Brucellosis is a zoonotic infection in which osteoarticular involvement occurs in 10-85% of patients. RF in brucellosis patients is significantly higher than in healthy people.
We presented 2 cases of brucellosis spondylodiscitis with positive results for RF and ACCP, which aroused great interest among the rheumatologists of our center.
Both patients described were men (27 and 60 years old) with arthritis, back pain, and high levels of rheumatoid arthritis-specific antibodies. These patients were suspected of having tuberculous spondylitis, but the tuberculous process was excluded using specific tests. During antibacterial therapy, there is a dynamic decrease in antirheumatoid antibodies. X-rays of the hand joints revealed no signs of erosive arthritis.
All cases of arthritis, spondylitis, and spondylodiscitis in endemic areas require careful analysis and comparison of patients' clinical and laboratory-instrumental data to prevent misdiagnosis. With brucellosis infection, against the background of adequate antibacterial therapy, inflammation of the joints and spine is reversible.
类风湿关节炎（RA）患者血清中常存在高滴度的抗环瓜氨酸肽特异性抗体（ACCP），其与类风湿因子（RF）一起是RA的诊断标志物。布鲁氏菌病是一种人畜共患感染，10%至85%的患者会出现骨关节受累。布鲁氏菌病患者的RF显著高于健康人。
我们报告了2例RF和ACCP结果呈阳性的布鲁氏菌病性脊椎间盘炎病例，这引起了我们中心风湿病学家的极大兴趣。
所描述的两名患者均为男性（分别为27岁和60岁），有关节炎、背痛以及高水平的类风湿关节炎特异性抗体。这些患者曾被怀疑患有结核性脊柱炎，但通过特定检查排除了结核病变。在抗菌治疗期间，抗类风湿抗体呈动态下降。手部关节X线检查未发现侵蚀性关节炎迹象。
在流行地区，所有关节炎、脊柱炎和脊椎间盘炎病例都需要仔细分析和比较患者的临床及实验室检查数据，以防止误诊。对于布鲁氏菌病感染，在充分的抗菌治疗背景下，关节和脊柱的炎症是可逆的。
