Management of reactive arthritis in a juvenile gorilla (Gorilla gorilla gorilla) with long-term sulfasalazine therapy

A juvenile western lowland gorilla (Gorilla gorilla gorilla) experienced recurrent fever, lethargy, diarrhea, and/or arthritis starting at age 6 mo. During an episode at age 15 mo, Shigella sp. was isolated from diarrheic feces. At age 41 mo, reactive arthritis was diagnosed. In addition, the gorilla's growth was retarded. All arthritic attacks were managed symptomatically prior to age 4 yr, at which time a severe episode precipitated the implementation of therapy with sulfasalazine, an arthritis suppressive medication. Examination 27 mo later revealed cessation of progressive joint pathology although the animal exhibited decreased range of motion in most joints. The gorilla has been on sulfasalazine therapy for 4 yr without lameness. Growth has resumed, and there has been no radiographic evidence of progressive joint degeneration. Immunogenetic analysis of whole blood obtained at age 68 mo identified the gorilla major histocompatibility class I allele, Gogo-B*0101, which has limited nucleotide sequence similarity to HLA-B27, an allele associated with postinfection reactive arthritis in humans. Sulfasalazine therapy effectively managed reactive arthritis in this gorilla and should be considered for similarly frequently affected animals. Juvenile gorillas, in populations with a history of clinical shigellosis and/or postdiarrhea arthritis, may benefit from prophylactic sulfasalazine therapy after episodes of bacterial enterocolitis. Sulfasalazine therapy should be considered in all gorillas, juvenile and adult, experiencing confirmed Shigella sp.-associated enterocolitis.