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MR Vol.12 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.2 |
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Reactive arthritis after pharyngeal infection:
report of two siblings |
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| J. Asakawa1, Y. Torikoe , I. Kondo1, M. Yasuda2,
S. Kobayashi3, H. Hashimoto3 |
(1)Department of Medicine, Yanagibashi Hospital,
2-20-4 Yanagibashi, Taito-ku, Tokyo 111-0052, Japan
(2)Department of Medicine, Nakaizu spa Hospital, Tagata-gun, Shizuoka, Japan
(3)Department of Rheumatology, Juntendo University, School of Medicine, Tokyo,
Japan |
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| Abstract |
| Abstract In this report we describe the cases
of two siblings with reactive arthritis (ReA) induced by pharyngeal
infections. The patients were a man and his sister living with their
parents. He developed arthritis in August 1997, and his younger sister
developed similar symptoms in September 1998. Their disease conditions
were both severe and required hospitalization. Their conditions improved
with the administration of nonsteroidal anti-inflammatory drugs together
with antibiotics, and both fully recovered within 1-2 weeks. Rheumatic
fever was ruled out since streptococcal infections were not demonstrated
with antistreptolysin O (ASO) or antistreptokinase (ASK) titers,
or with pharyngeal culture. The sister suffered from a rash which
was similar to erythema nodosum on her lower extremities, but neither
chorea nor carditis was observed. Both human leukocyte antigen (HLA)
typing analyses revealed positive results for HLA-B40 and -B39 for
the brother and sister, respectively. Both HLA-B40 and -B39 are considered
to be related to HLA-B27-negative ReA, most likely poststreptococcal
reactive arthritis (PSRA). Therefore, the two patients were tentatively
diagnosed as suffering from PSRA. |
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| Key words |
| Key words Group-A streptococcal infection
・ Human leukocyte antigen (HLA)-B27, 39, 40 ・ Human leukocyte antigen
(HLA) typing ・ Reactive
arthritis (ReA) |
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