Læknablaðið : fylgirit - 01.05.1978, Side 106

Læknablaðið : fylgirit - 01.05.1978, Side 106
Table 2. Numoer, sex and age of HLA-B27 positive and negative patients HLA-B27 positive negative No. of patients 31 17 Female/male ratio 14/17 12/5 Age Mean 3? 35 Range 17-59 15-64 Table 3. Yersinia enterocolitica (serotype 3 or 9) agglutinins in yersinia arthritis patients HLA-B27 positive neqative (31 cases) (17 cases) Mean 3120 1210 Range 160-10240 80-5120 As far as the rheumatological history between the two groups is concerned there was a difference between the B27 positive and negative yersinia arthritis patients. Three cases out of the 31 B27 positive cases had suffered from classical and ankylosing spondylitis for 4, 10 and 13 years before acute yersinia arthritis. Because the prevalence of ankylosing spondylitis is between 0.5 and 2°/oo in the population studies carried out in Finland and in different other countries and because this should be less than 4% even in B27 positive male individuals, the frequency of anky- losing spondylitis in this material is imexpectedly high - three (18%) out of 17 HLA B27 positive male patients (Table 5). This suggests that B27 positive spondylarthritis ankylopoetica patients are probabiy even more susceptible to B27 positive forms af reactive arthritis than B27 positive individuals in general. During the reTativeiy short follow-up period none of our patients developed new signs of sacroilitis, but the fact that patients with anky- losing spondyliíis are particularly susceptible to certain infections possibly supports the theory that ankylosing spondylitis is a form of reactive arthritis. Aho and coworkers in Finland (3) have reported that yersinia arthritis may be associated with signs of Reiter’s syndrome during the acute yersinia arthritis. In this material 3 patients developed Reiter's syndrome during their acute yersinia arthritis and in addition one had Reiter s disease in his history. None of the B27 negative patients had signs of Reiter's syndrome during their disease. On the basis of this data it seems probable that yersinia infection should be added to the previously known etiologic trigger organisms of Reiter's syndrome. Furthermore, also this 101
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