Abstract
Chlamydia trachomatis-triggered reactive arthritis is a well-documented entity that has been extensively described. We do not have a clear understanding about the inflammatory oligoarthritis associated with the presence of this organism. It is rarely cultured from the synovial fluid, but is usually detectable by molecular biological techniques. Typically, Chlamydia trachomatis causes a sterile but inflammatory oligoarthritis. We report an unusual case of inflammatory monoarthritis in a young woman in whom Chlamydia was isolated from the synovial fluid. This is the first case of documented isolation of Chlamydia from synovial fluid, which subseqently was diagnosed as rheumatoid arthritis.
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Siboulet A, Galistin P (1962) Arguments in favour of a virus aetiology of non-gonococcal urethritis illustrated by three cases of Reiter’s disease. Br J Venereal Dis 38:209
Schachter J, Barnes J, Jones P Jr et al (1966) Isolation of Bedsoniae from the joints of patients with Reiters syndrome. Proc Soc Exp Biol Med 122:283–285
Dunlop EMC, Harper IA, Jones BR (1968) Seronegative polyarthritis: The Bedsonia (chlamydia) group of agents and Reiter’s disease. Ann Rheum Dis 27:234–240
Engleman EP, Schachter J, Gilbert RJ et al (1969) Bedsonia and Reiter’s syndrome: A progress report (abstract). Arthritis Rheum 12:292
Ford DK, McCandish L (1971) Isolation of human genital TRIC agents in non gonococcal urethritis and Reiter”s disease by an irradiated cell culture method. Br J Venereal Dis47:196–197
Gordon FB, Quan AL, Steinman TI et al (1973) Chlamydial isolates from Reiter’s syndrome. Br J Venereal Dis 49:376–378
Keat A, Dixey J, Soonex C et al (1987) Chlamydia trachomatis and reactive arthritis: the missing link. Lancet i.:72–74
Norton WL, Lewis D, Ziff M (1966) Light and electron microscopic observation on the synovitis of Reiter’s disease. Arthritis Rheum 9:747–757
Ishikawa H, Ohno O, Yamasaki K et al (1986) Arthritis presumably caused by chlamydia in Reiter’s syndrome. Case report with electron microscopic studies. J Bone Joint Surg (Am) 68:777–779
Schumacher HR Jr., Cherian PV, Sieck M, Clayburne G (1986) Ultrastructural identification of chlamydial antigens in synovial membrane in acute Reiter’s syndrome (abstract). Arthritis Rheum 29 (Suppl 4):S31
Schumacher HR Jr, Magge S, Cherian PV et al (1988) Light and electron microscopic studies on the synovial membrane in Reiter’s syndrome. Immunocytochemical identification of chlamydial antigen in patients with early disease. Arthritis Rheum 31:937–946
Inman RD, Morrison RP (1990) Immunoblot analysis of reactivity to chlamydial 57 kD heat shock protein in Reiter’s syndrome (abstract). Arthritis Rheum 33[Suppl]: S26
Taylor- Robinson D, Gilroy CB, Thomas BJ et al. (1992) Detection of chlamydia trachomatis DNA in joints of reactive arthritis patients by polymerase chain reaction. Lancet 340:81–82
Beutler A, Hudson JW, Nanagara R et al. (1994)Demonstration of chlamydia trachomatis by in situ hybridization in synovial membranes of patients with chronic reactive arthritis. Arthritis Rheum 37[Suppl 9]:S233
Rahman MU, Schumacher HR, Hudson AP (1992) Recurrent arthritis in Reiter’s syndrome: a function of inapparent chlamydial infection of the synovium? Semin Arthritis Rheum21:259–266
Nanagara R, Li F, Beutler A et al. (1995) Alteration of chlamydia trachomatis biologic behavior in synovial membranes: suppression of surface antigen production in reactive arthritis and Reiter’s syndrome. Arthritis Rheum 38:1410–1417
Kuipers JG, Kohler et al. (1999) Reactive or infectious arthritis. Ann Rheum Dis 58:661–664
Ford DK, Reid GD, Magge S, Schumacher R (1988) Synovial lymphocyte response to the chlamydial stimulation associated with intrasynovial chlamydial antigen in a patient with “Rheumatoid arthritis”. Arthritis Rheum 31:914–917
Ford DK (1933) Synovial lymphocytes can indicate specific microbiologic causes of rheumatoid arthritis. Arthritis Rheum 36:1350–1352
Ford DK, Schulzer M (1994) Synovial lymphocytes indicate “ Bacterial”agents may cause some cases of rheumatoid arthritis. J Rheumatol 21:1447–1449
Heijden IMVD, Wilbrink B, Tchetverikov I et al. (2000) Presence of bacterial DNA and bacterial peptidoglycans in joints of patients with rheumatoid arthritis and other arthritides. Arthritis Rheum43:593–598
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We would like to thank Dr Michael Ellman for his invaluable guidance in preparation of the manuscript.
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Jolly, M., Curran, J.J. Chlamydial infection preceding the development of rheumatoid arthritis: a brief report. Clin Rheumatol 23, 453–455 (2004). https://doi.org/10.1007/s10067-004-0904-9
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DOI: https://doi.org/10.1007/s10067-004-0904-9