Postdysenteric reactive arthritis. A clinical and immunogenetic study following an outbreak of salmonellosis

Arthritis Rheum. 1988 Nov;31(11):1377-83. doi: 10.1002/art.1780311106.

Abstract

Following an outbreak of foodborne gastroenteritis caused by Salmonella typhimurium, questionnaires were sent to affected individuals and then to the family physicians of any who experienced extra-enteric complications. Of 260 individuals infected with S typhimurium for whom adequate data were obtained, 19 patients developed joint disease (7.3%). All were men; the mean age +/- SD was 39.3 +/- 1.6 years. Among the 16 patients for whom this information was available, the interval from the onset of diarrhea to the onset of joint pain was less than 7 days in 7, 8-21 days in 2, and greater than 21 days in 7. There was a significantly longer duration of diarrhea in those patients with joint disease (mean +/- SEM 15.2 +/- 2.6 days) than in those without complications (10.0 +/- 1.1 days) (P less than 0.01). The joint disease was monarticular in 3 patients and polyarticular in 16. The joints most commonly affected were the elbow (47%), wrist (47%), knee (42%), low back (32%), and shoulder (32%). Six of the 19 patients had at least 1 extraarticular feature: ocular (5 patients), mucosal (1 patient), urethral (2 patients), or cutaneous (1 patient). Of these 19 patients, 11 were located and agreed to HLA typing. Four were positive for HLA-B27, 6 were HLA-B7 positive, and 1 had HLA-Bw60. Of the 4 B27 positive patients, 3 were DR1 positive; of the 6 B7 positive patients, 5 were DR2 positive.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adult
  • Arthritis / genetics
  • Arthritis, Infectious / etiology*
  • Arthritis, Infectious / genetics
  • Arthritis, Infectious / immunology
  • Arthritis, Reactive / etiology
  • Canada
  • Disease Outbreaks
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / etiology
  • HLA Antigens / classification
  • Humans
  • Joints / pathology
  • Joints / physiopathology
  • Male
  • Pain
  • Salmonella Infections* / complications

Substances

  • HLA Antigens