[Efficacy of cyclines in agammaglobulinemia arthritis]

Five to 40% of patients with agammaglobulineamia develop joint manifestation consisting of septic arthritis or aseptic arthritis of unclear pathogenesis. Intravenous gamma-globulin therapy seems effective on the better condition but is burden-some and expensive. We report the case of a 31-year old woman, having a common variable immunodeficiency that has a chronic oligoarthritis seronegative and not warping. Substitutive treatment with gamma-globulins resulted in a poor improvement. Blood Lymphocyte immunotyping ans analysis of synovial fluid showed high levels of CD8 with a low CD4/CD8 ratio. Synovial biopsy revealed a non specific synovitis with an lymphoid aggregates with a significant predominance of CD8 cells and suspicion of mycoplasm, only after centrifugation, justifying PCR techniques. Doxycycline therapy was effective in relieving the joint symptoms with six month recession.