Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1980 Oct;39(5):431–437. doi: 10.1136/ard.39.5.431

Evidence of Chlamydia trachomatis infection in sexually acquired reactive arthritis.

A C Keat, B J Thomas, D Taylor-Robinson, G D Pegrum, R N Maini, J T Scott
PMCID: PMC1000580  PMID: 6893652

Abstract

Thirty male patients with sexually acquired reactive arthritis (SARA) have been studied at the time of their initial presentation and thereafter. Chlamydia trachomatis was isolated from the urethral exudate of 9 (36.0%) of the 25 patients from whom urethral specimens were taken, and elevated titres of IgM antibody of C. trachomatis were detected in 11 (36.6%) of the 30 initial sera. Thirteen (43.3%) of the patients has a positive urethral culture and/or elevated titre of IgM antibody, and it is therefore suggested that 43.3% of these patients suffered an acute chlamydial infection at or near the time of the onset of their joint disease. The demonstration of 4-fold or greater rises and/or falls in IgM antibody titre (8 patients) and IgG antibody titre (6 patients) in a group of 15 men studied throughout the course of their disease strongly supports this conclusion. A positive urethral culture and/or raised titre of IgM serum antibody was also detected in 25 (50%) of 50 men with uncomplicated nongonococcal urethritis (NGU), suggesting that the prevalence of chlamydial infections in the 2 conditions is similar. Titres of IgG serum antibody to C. trachomatis were, however, significantly higher in patients with SARA than in those with NGU or other rheumatic diseases, and in healthy controls. The geometric mean titres (GMT) of IgG serum antibody in patients with SARA, NGU, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, and in healthy controls were 1:47.5, 1:8.6, 1:2.2, 1;2.2, 1:3.5, and 1:1.4, respectively. These findings suggest that an exaggerated antibody response to acute infection by C. trachomatis may be an important factor in the development of SARA in some but not all patients.

Full text

PDF
434

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aho K., Ahvonen P., Lassus A., Sievers K., Tiilikainen A. HL-A 27 in reactive arthritis. A study of Yersinia arthritis and Reiter's disease. Arthritis Rheum. 1974 Sep-Oct;17(5):521–526. doi: 10.1002/art.1780170505. [DOI] [PubMed] [Google Scholar]
  2. Bowie W. R., Wang S. P., Alexander E. R., Floyd J., Forsyth P. S., Pollock H. M., Lin J. S., Buchanan T. M., Holmes K. K. Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum. J Clin Invest. 1977 May;59(5):735–742. doi: 10.1172/JCI108694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Holmes K. K., Handsfield H. H., Wang S. P., Wentworth B. B., Turck M., Anderson J. B., Alexander E. R. Etiology of nongonococcal urethritis. N Engl J Med. 1975 Jun 5;292(23):1199–1205. doi: 10.1056/NEJM197506052922301. [DOI] [PubMed] [Google Scholar]
  4. Keat A. C., Maini R. N., Nkwazi G. C., Pegrum G. D., Ridgway G. L., Scott J. T. Role of Chlamydia trachomatis and HLA-B27 in sexually acquired reactive arthritis. Br Med J. 1978 Mar 11;1(6113):605–607. doi: 10.1136/bmj.1.6113.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Keat A. C., Maini R. N., Pegrum G. D., Scott J. T. The clinical features and HLA associations of reactive arthritis associated with non-gonococcal urethritis. Q J Med. 1979 Apr;48(190):323–342. [PubMed] [Google Scholar]
  6. Kousa M., Saikku P., Richmond S., Lassus A. Frequent association of chlamydial infection with Reiter's syndrome. Sex Transm Dis. 1978 Apr-Jun;5(2):57–61. doi: 10.1097/00007435-197804000-00004. [DOI] [PubMed] [Google Scholar]
  7. Oriel J. D., Reeve P., Powis P., Miller A., Nicol C. S. Chlamydial infection. Isolation of Chlamydia from patients with non-specific genital infection. Br J Vener Dis. 1972 Dec;48(6):429–436. doi: 10.1136/sti.48.6.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Philip R. N., Casper E. A., Gordon F. B., Quan A. L. Fluorescent antibody responses to chlamydial infection in patients with lymphogranuloma venereum and urethritis. J Immunol. 1974 Jun;112(6):2126–2134. [PubMed] [Google Scholar]
  9. Reeve P., Gerloff R. K., Casper E., Philip R. N., Oriel J. D., Powis P. A. Serological studies on the role of Chlamydia in the aetiology of non-specific urethritis. Br J Vener Dis. 1974 Apr;50(2):136–139. doi: 10.1136/sti.50.2.136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Reeve P., Owen J., Oriel J. D. Laboratory procedures for the isolation of chlamydia trachomatis from the human genital tract. J Clin Pathol. 1975 Nov;28(11):910–914. doi: 10.1136/jcp.28.11.910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Richmond S. J., Caul E. O. Fluorescent antibody studies in chlamydial infections. J Clin Microbiol. 1975 Apr;1(4):345–352. doi: 10.1128/jcm.1.4.345-352.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Richmond S. J., Oriel J. D. Recognition and management of genital chlamydial infection. Br Med J. 1978 Aug 12;2(6135):480–483. doi: 10.1136/bmj.2.6135.480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. TERASAKI P. I., MCCLELLAND J. D. MICRODROPLET ASSAY OF HUMAN SERUM CYTOTOXINS. Nature. 1964 Dec 5;204:998–1000. doi: 10.1038/204998b0. [DOI] [PubMed] [Google Scholar]
  14. Vaughan-Jackson J. D., Dunlop E. M., Darougar S., Dwyer R. S., Jones B. R. Chlamydial infection. Results of tests for Chlamydia in patients suffering from acute Reiter's disease compared with results of tests of the genital tract and rectum in patients with ocular infection due to TRIC agent. Br J Vener Dis. 1972 Dec;48(6):445–451. doi: 10.1136/sti.48.6.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wang S. P., Grayston J. T. Human serology in Chlamydia trachomatis infection with microimmunofluorescence. J Infect Dis. 1974 Oct;130(4):388–397. doi: 10.1093/infdis/130.4.388. [DOI] [PubMed] [Google Scholar]
  16. Wang S. P., Grayston J. T. Immunologic relationship between genital TRIC, lymphogranuloma venereum, and related organisms in a new microtiter indirect immunofluorescence test. Am J Ophthalmol. 1970 Sep;70(3):367–374. doi: 10.1016/0002-9394(70)90096-6. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES