Læknablaðið : fylgirit - 01.05.1978, Page 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
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