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

Abstract

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.

Reiter's syndrome: The classic triad and more

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

Immunogenetics and infectious diseases: special reference to the mayor histocompatibility complex

“…It manifests itself from one to four weeks after an episode of genitourinary or gastrointestinal tract infection by Chlamydia, Ureoplasma, Shigella, Yersinia, among other bacteria, and its occurrence is also related to the HLA-B27 antigen. In addition, some studies suggest an association of this syndrome with the HLA-B51 antigen in Japanese patients who do not have HLA-B27 [35,36]. As they are related to the same HLA antigen, an association between ankylosing spondylitis, anterior uveitis and Reiter syndrome is common [28].…”

A case of Reiter′s disease exacerbated by lithium

“…[3] Associations with HLA-B7, -Bw60, -B39 and recently -B-51 have been reported. [4] Management includes aspirin or other nonsteroidal anti-inflammatory drugs for arthritis, topical salicylic acid and steroids for cutaneous lesions, and antibiotics for urethritis depending on culture results. [5]…”