Læknablaðið : fylgirit - 01.05.1978, Qupperneq 107

Læknablaðið : fylgirit - 01.05.1978, Qupperneq 107
Table 4. Joint involvement in yersinia arthritis patients HLA-B27 positive (31 cases) negative (17 cases) Polyarthritis 28 14 Monoarthritis 3 3 Duration of acute phase: - 1 month 5 7 1-3 months 8 8 > 3 months 18 2 Knee 23(11) 9(8) Ankle 16(6) 12 (8) Toe 10 3(1) Finger 18(12) 12(11) Wrist 5(1) 6(4) Elbow 2 “ Number of bilateral involvement in parentheses finding supports the concept that B27 positive patients with some previous "B27 positive rheumatic disease" are especially susceptible to develop another disease of this group. It may well be that such patients have other factors besides B27 which make them prone to "B27 positive rheumatic diseases." Aho and coworkers have shown that patients with yersinia infection without joint symptoms have normal frequeney of B27, whereas most patients with yersinia arthritis are B27 positive (3). If we compare B27 positive and negative patients in this material it also seems that two other signs of local inflammation, iritis (also in harmony with the findings by Aho et al.) and carditis, occur more often in B27 positive patients. Five patients out of the 48 who had iritis and all the five who had definite signs of carditis were B27 positive, and four patients out of the 6 who had changes in their ECG were B27 positive (Table 6). If these symptoms of local inflammation are viewed as one group the differ- ence between the groups is statistically signifi- cant. Consequently, it seems that in addition to joint involvement, symptoms of local inflamma- tion in the other organs also have a positive correlation with B27 (see also the correlation of urological signs and B27 below). 12 patients with B27 had signs of urological inflammation either in their history or during the acute yersinia arthritis (Table 7). With the exception of one B27 negative patient, all cases with urological symptoms were B27 positive and even the only B27 negative case was a borderline one: he had only 5-10 white cells and some red cells in routine microscopic examination. Acute, often rapidly subsiding urological symptoms in association with yersinia arthritis may well be comparable with the previously mentioned local inflammations (acute carditis or iritis) in B27. positive patients. By contrast, the significance of chronic urological infections in the B27 positive group remains obscure but it is possible that it has a role in their etiopathogenesis (4). Table 8 shows the HLA-B27 frequencies in 105
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