Reactive Arthritis or Reiter''s Syndrome and B51-associated Seronegative Spondyloarthropathy

Kobayashi, Shigeto; Ando, Soichiro

doi:10.2169/internalmedicine.39.89

Cited by 7 publications

(6 citation statements)

References 4 publications

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“…It is important to study HLA typing in Japanese patients with SNSA since the incidence of B27 is less than 1% in Japan. 21 A positive family history of a definite SpA, predominantly AS, was mentioned in 9% of the patients, similar to that observed in AS or Reiter's syndrome. 22 The presence of uSpA in SNSA is common in the families of patients with AS, predominantly those who are HLA-B27-positive patients, 23 and can also be associated with HLA-B7 CREG antigens.…”

Section: Discussionsupporting

confidence: 68%

“…24 In addition to B27, the antigens that cross-react with B27 antigens are encoded by some alleles that have also been linked to AS and Reiter's syndrome. 21 It was reported that the amino acid sequence of the B pocket in B27 was homologous to that of B39. 25,26 From these reports and our results (Table 1), it is suggested that various HLA alleles beyond B27 may also play roles in the pathogenesis of SNSA.…”

Section: Discussionmentioning

confidence: 99%

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A study of ten Japanese patients with seronegative spondylarthropathy: a tentative proposal

Higashi¹,

Nakamura²,

Tomoda³

et al. 2005

Mod Rheumatol

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We reviewed ten patients with seronegative spondylarthropathy (SNSA), who all fulfilled the European Spondylarthropathy Study Group criteria for spondylarthropathy (SpA); seven patients also met the Amor criteria for SpA. Seronegative spondylarthropathy was not a uniform syndrome but rather a wide spectrum of complex disease with characteristics of sacroiliitis and enthesopathy. The most frequent symptom at diagnosis of SNSA was inflammatory low back pain, followed by asymmetric oligoarthralgia and Achilles tendonitis and/or plantar fasciitis. Systemic complications were revealed as eye and skin involvement. Imaging methods including pelvic radiography, scintigraphy, and computed tomography scanning were useful in detecting spondylarthropathic changes, which were characteristic of SNSA. Human leukocyte antigen (HLA) typing showed various patterns among patients, in which HLA-B27 was positive in three patients with ankylosing spondylitis. HLA-B51, which is a well-known genetic factor associated with Behçet's disease (BD), was positive in two patients who were apparently distinct from BD. Two patients with palmoplantar pustulosis showed symptoms and signs characteristic of SNSA. Although we have few SNSA patients in the present study, we would like to propose that HLA-B51 positive SpA would be considered as a subset of SNSA, and that pustulotic SpA also would be classified as a member of SNSA. This led us to suggest the possibility to change the concept of SNSA proposed by Moll et al. The optimal treatment remains to be defined, but sulfasalazine was effectively used with almost all patients in combination with nonsteroidal anti-inflammatory drugs.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

A study of ten Japanese patients with seronegative spondylarthropathy: a tentative proposal

Higashi¹,

Nakamura²,

Tomoda³

et al. 2005

Mod Rheumatol

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“…41 Some case reports have also noted a possible association of reactive arthritis with HLA-B51. 42,43 …”

Section: Epidemiologymentioning

confidence: 99%

Reiter's syndrome: The classic triad and more

Schwartz²

2008

Journal of the American Academy of Dermatology

165

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“…Recently, it was reported that the combination of Chlamydia infection and HLA-B51 might play a role in the pathogenesis of Reiter's syndrome, 7 and it has also been suggested that HLA-B51 is implicated in the pathogenesis of reactive arthritis. 8 In this case report, the Japanese patient with Reiter's syndrome was positive for HLA-B51, but negative for HLA-B27. These observations suggest that HLA-B51 may play a role in the pathogenesis of Reiter's syndrome in the Japanese population, but further studies to confirm these findings using a large sample from the same population are needed.…”

Section: Discussionmentioning

confidence: 69%

Reiter's Syndrome Associated with HLA-B51: A Case Report

et al. 2003

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A 32-year-old Japanese man developed polyarthritis with mild fever and conjunctivitis. Clinical assessment indicated non-specific arthritis, aseptic pyuria induced by infection with Chlamydia, and conjunctivitis. He was diagnosed with reactive arthritis (Reiter's syndrome). Serotyping of human leucocyte antigen (HLA) class I and II revealed positivity for B51(5), A2, A33(19), B44(12), Cw1, DR4 and DR6, but B27 was negative. He was treated with a combination of doxycycline, oral prednisolone, diclofenac sodium and salazosulphapyridine. Fever and arthralgia improved and he became negative for anti-Chlamydia immunoglobulin (Ig) A and IgG antibodies. HLA-B51 may be involved in the pathogenesis of Reiter's syndrome in this Japanese patient.

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Reactive Arthritis or Reiter''s Syndrome and B51-associated Seronegative Spondyloarthropathy

Cited by 7 publications

References 4 publications

A study of ten Japanese patients with seronegative spondylarthropathy: a tentative proposal

A study of ten Japanese patients with seronegative spondylarthropathy: a tentative proposal

Reiter's syndrome: The classic triad and more

Reiter's Syndrome Associated with HLA-B51: A Case Report

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