{"created":"2023-05-15T16:29:33.206274+00:00","id":342,"links":{},"metadata":{"_buckets":{"deposit":"403d0cf2-f935-4ad6-8ad4-e102b024ca37"},"_deposit":{"created_by":2,"id":"342","owners":[2],"pid":{"revision_id":0,"type":"depid","value":"342"},"status":"published"},"_oai":{"id":"oai:nagasaki-u.repo.nii.ac.jp:00000342","sets":["10:11"]},"author_link":["1656","1658","1655","1652","1653","1657","1654","1662","1663","1650","1659","1660","1649","1661","1651","1647","1648"],"item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-10","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"40","bibliographicPageStart":"e17233","bibliographicVolumeNumber":"98","bibliographic_titles":[{"bibliographic_title":"Medicine"}]}]},"item_2_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"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.","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). 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"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00257974","subitem_source_identifier_type":"ISSN"}]},"item_2_version_type_16":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Sumiyoshi, Remi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Koga, Tomohiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Tsuji, Sosuke"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Endo, Yushiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Takatani, Ayuko"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Shimizu, Toshimasa"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Igawa, Takashi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Umeda, Masataka"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Fukui, Shoichi"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Nishino, Ayako"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kawashiri, Shin-ya"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Iwamoto, Naoki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Ichinose, Kunihiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Tamai, Mami"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Nakamura, Hideki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Origuchi, Tomoki"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Kawakami, Atsushi"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-12-18"}],"displaytype":"detail","filename":"Medicine98_17233.pdf","filesize":[{"value":"583.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"Medicine98_17233.pdf","url":"https://nagasaki-u.repo.nii.ac.jp/record/342/files/Medicine98_17233.pdf"},"version_id":"4725af0e-6c13-4048-a816-6a51be6a0bfb"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Chlamydia-induced reactive arthritis","subitem_subject_scheme":"Other"},{"subitem_subject":"cytokine profiles","subitem_subject_scheme":"Other"},{"subitem_subject":"gout","subitem_subject_scheme":"Other"},{"subitem_subject":"HLA-B27","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Chlamydia-induced reactive arthritis diagnosed during gout flares","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Chlamydia-induced reactive arthritis diagnosed during gout flares"}]},"item_type_id":"2","owner":"2","path":["11"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-10-25"},"publish_date":"2019-10-25","publish_status":"0","recid":"342","relation_version_is_last":true,"title":["Chlamydia-induced reactive arthritis diagnosed during gout flares"],"weko_creator_id":"2","weko_shared_id":-1},"updated":"2023-05-16T04:18:22.269162+00:00"}