Leirisalo-Repo M, Helenius P, Hannu T, Lehtinen A, Kreula J, Taavitsainen M, Koskimies S
Department of Medicine, Helsinki University Central Hospital, Finland.
Ann Rheum Dis. 1997 Sep;56(9):516-20. doi: 10.1136/ard.56.9.516.
Reactive joint complications triggered by salmonella gastroenteritis are increasingly reported, but the outcome and long term prognosis of the patients is incompletely known. This study looked at the prognosis of salmonella arthritis in patients hospitalised in 1970-1986.
Hospital records from two hospitals in southern Finland were screened for patients with the discharge diagnosis of salmonellosis or reactive, postinfectious arthritis or Reiter's disease. For the patients with confirmed diagnosis of reactive salmonella arthritis, data about the acute disease were collected from the hospital records. A follow up study was performed.
There were 63 patients (28 women, 35 men, mean age 36.5 years) with salmonella arthritis. Urethritis occurred in 27%, eye inflammation in 13%, and low back pain in 44% of the patients. HLA-B27 was present in 88%. More men than women were HLA-B27 positive. HLA-B27 positive patients had higher erythrocyte sedimentation rate (mean 80.9 v 46.5 mm 1st h, p = 0.0180). Also, extra-articular features and radiological sacroiliitis were seen only in HLA-B27 positive patients. A follow up study was performed on 50 patients mean 11.0 (range 5-22 years) later. Twenty patients had recovered completely. Ten patients had mild joint symptoms, 11 patients had had a new acute transient arthritis, and five acute iritis. Eight patients had developed chronic spondyloarthropathy. Radiological sacroiliitis was seen in six of 44 patients, more frequently in male than in female patients (32% v 0%; p = 0.0289). Recurrent or chronic arthritis, iritis or radiological sacroiliitis developed only in HLA-B27 positive patients.
Joint symptoms are common after reactive salmonella arthritis. HLA-B27 contributes to the severity of acute disease and to the late prognosis.
由沙门氏菌肠胃炎引发的反应性关节并发症报告日益增多，但患者的结局和长期预后尚不完全清楚。本研究观察了1970年至1986年住院的沙门氏菌关节炎患者的预后情况。
对芬兰南部两家医院的住院记录进行筛查，找出出院诊断为沙门氏菌病或反应性、感染后关节炎或赖特综合征的患者。对于确诊为反应性沙门氏菌关节炎的患者，从住院记录中收集有关急性疾病的数据。进行了一项随访研究。
有63例沙门氏菌关节炎患者（28名女性，35名男性，平均年龄36.5岁）。27%的患者发生尿道炎，13%的患者出现眼部炎症，44%的患者有腰痛。88%的患者存在HLA - B27。HLA - B27阳性的男性多于女性。HLA - B27阳性患者的红细胞沉降率更高（平均80.9对46.5 mm第1小时，p = 0.0180）。此外，仅在HLA - B27阳性患者中出现关节外表现和放射学骶髂关节炎。对50例患者平均在11.0（范围5 - 22年）后进行了随访研究。20例患者已完全康复。10例患者有轻度关节症状，11例患者发生了新的急性短暂性关节炎，5例有急性虹膜炎。8例患者发展为慢性脊柱关节病。44例患者中有6例出现放射学骶髂关节炎，男性患者比女性患者更常见（32%对0%；p = 0.0289）。复发性或慢性关节炎、虹膜炎或放射学骶髂关节炎仅在HLA - B27阳性患者中出现。
反应性沙门氏菌关节炎后关节症状常见。HLA - B27导致急性疾病的严重程度和晚期预后。
