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However, the precise cytokine profile of cases with a coexistence of both diseases is unknown, and there are few reports on the course of treatment in patients with both gouty arthritis and ReA.Patient concerns:A 39-year-old man with a recurrent episode of gouty arthritis presented prednisolone-resistant polyarthritis with high level of C-reactive protein (CRP). He had the features of gouty arthritis such as active synovitis of the first manifestation of metatarsophalangeal (MTP) joints and the presence of monosodium urate (MSU) crystals from synovial fluid. But he also had the features of ReA such as the presence of tenosynovitis in the upper limb, the positivity of human leukocyte antigen (HLA)-B27, a history of sexual contact and positive findings of anti-Chlamydia trachomatis-specific IgA and IgG serum antibodies.Diagnoses:He was diagnosed with HLA-B27 associated Chlamydia-induced ReA accompanied by gout flares.Interventions:He was treated with 180 mg/day of loxoprofen, 1 mg/day of colchicine, and 10 mg/day of prednisolone for gout flares. However, his polyarthritis worsened with an increased level of CRP (23.16 mg/dL). Accordingly, we added 500 mg/day of salazosulfapyridine followed by adalimumab (ADA) 40 mg once every 2 weeks.Outcomes:After starting ADA, the patient\u0027s symptoms and laboratory findings showed rapid improvement and he achieved clinical remission 1 month after initiation of ADA treatment. As of this writing, the patient\u0027s clinical remission has been maintained for \u003e1 year.Lessons:This case suggests that with exacerbation of arthritis during gouty arthritis, coexistence with other pathologies such as peripheral spondyloarthritis should be considered, and early intensive treatment including tumor necrosis factor inhibitors may be necessary.", "subitem_description_type": "Other"}]}, "item_2_description_63": {"attribute_name": "引用", "attribute_value_mlt": [{"subitem_description": "Medicine, 98(40), e17233; 2019", "subitem_description_type": "Other"}]}, "item_2_publisher_33": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "Wolters Kluwer Health, Inc."}]}, "item_2_relation_12": {"attribute_name": "DOI", "attribute_value_mlt": [{"subitem_relation_type": "isIdenticalTo", "subitem_relation_type_id": {"subitem_relation_type_id_text": "10.1097/MD.0000000000017233", "subitem_relation_type_select": "DOI"}}]}, "item_2_rights_13": {"attribute_name": "権利", "attribute_value_mlt": [{"subitem_rights": "c 2019 the Author(s). 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Chlamydia-induced reactive arthritis diagnosed during gout flares
http://hdl.handle.net/10069/39504
http://hdl.handle.net/10069/39504cf7e7729-f752-49df-b68f-0a2cc08dcb43
名前 / ファイル | ライセンス | アクション |
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Medicine98_17233.pdf (583.1 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2019-10-25 | |||||
タイトル | ||||||
タイトル | Chlamydia-induced reactive arthritis diagnosed during gout flares | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Chlamydia-induced reactive arthritis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | cytokine profiles | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | gout | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | HLA-B27 | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Sumiyoshi, Remi
× Sumiyoshi, Remi× Koga, Tomohiro× Tsuji, Sosuke× Endo, Yushiro× Takatani, Ayuko× Shimizu, Toshimasa× Igawa, Takashi× Umeda, Masataka× Fukui, Shoichi× Nishino, Ayako× Kawashiri, Shin-ya× Iwamoto, Naoki× Ichinose, Kunihiro× Tamai, Mami× Nakamura, Hideki× Origuchi, Tomoki× Kawakami, Atsushi |
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内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Rationale:The pathology of gouty arthritis and reactive arthritis (ReA) partially overlaps, and both diseases are characterized by the production of inflammatory cytokines associated with the activation of monocytes and macrophages. However, the precise cytokine profile of cases with a coexistence of both diseases is unknown, and there are few reports on the course of treatment in patients with both gouty arthritis and ReA.Patient concerns:A 39-year-old man with a recurrent episode of gouty arthritis presented prednisolone-resistant polyarthritis with high level of C-reactive protein (CRP). He had the features of gouty arthritis such as active synovitis of the first manifestation of metatarsophalangeal (MTP) joints and the presence of monosodium urate (MSU) crystals from synovial fluid. But he also had the features of ReA such as the presence of tenosynovitis in the upper limb, the positivity of human leukocyte antigen (HLA)-B27, a history of sexual contact and positive findings of anti-Chlamydia trachomatis-specific IgA and IgG serum antibodies.Diagnoses:He was diagnosed with HLA-B27 associated Chlamydia-induced ReA accompanied by gout flares.Interventions:He was treated with 180 mg/day of loxoprofen, 1 mg/day of colchicine, and 10 mg/day of prednisolone for gout flares. However, his polyarthritis worsened with an increased level of CRP (23.16 mg/dL). Accordingly, we added 500 mg/day of salazosulfapyridine followed by adalimumab (ADA) 40 mg once every 2 weeks.Outcomes:After starting ADA, the patient's symptoms and laboratory findings showed rapid improvement and he achieved clinical remission 1 month after initiation of ADA treatment. As of this writing, the patient's clinical remission has been maintained for >1 year.Lessons:This case suggests that with exacerbation of arthritis during gouty arthritis, coexistence with other pathologies such as peripheral spondyloarthritis should be considered, and early intensive treatment including tumor necrosis factor inhibitors may be necessary. | |||||
書誌情報 |
Medicine 巻 98, 号 40, p. e17233, 発行日 2019-10 |
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出版者 | ||||||
出版者 | Wolters Kluwer Health, Inc. | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 00257974 | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1097/MD.0000000000017233 | |||||
権利 | ||||||
権利情報 | c 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Medicine, 98(40), e17233; 2019 |