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Chlamydial associated syndrome of arthritis and eye involvement in young children
A A Maximov1, A V Shaikov, D J Lovell
1Children's Clinic, Institute of Rheumatology, Moscow, USSR.
Insights
Chlamydia trachomatis infection can cause arthritis and eye inflammation in young children, mimicking juvenile rheumatoid arthritis (JRA). Further research is needed for diagnosis and treatment of this post-infectious syndrome.
Area of Science:
- Pediatric Rheumatology
- Infectious Diseases
- Ophthalmology
Background:
- Juvenile rheumatoid arthritis (JRA) has several distinct classifications.
- Chlamydia trachomatis is a common bacterial pathogen.
Purpose of the Study:
- To describe a series of children with arthritis and eye involvement linked to Chlamydia trachomatis infection.
- To compare the clinical presentation to early-onset pauciarticular JRA and Reiter's disease.
Main Methods:
- Case series describing 6 children (2 boys, 4 girls) with arthritis and ocular inflammation.
- Clinical data collection including age of onset, joint involvement, uveitis, and autoantibody status.
- Assessment for symptoms consistent with Reiter's disease.
Main Results:
- Six children presented with arthritis and ocular inflammation associated with Chlamydia trachomatis.
- Clinical features in some children resembled early-onset pauciarticular JRA (early onset, female predominance, pauciarticular arthritis, uveitis, antinuclear antibodies).
- Four patients had pauciarticular arthritis, two had polyarticular arthritis, and two exhibited symptoms of Reiter's disease.
Conclusions:
- Chlamydia trachomatis infection may be associated with a distinct syndrome of arthritis and uveitis in children.
- This post-chlamydial syndrome can mimic juvenile rheumatoid arthritis and Reiter's disease.
- Further investigation is warranted to establish diagnostic, therapeutic, and prognostic guidelines.
Abstract:
The current classification of juvenile rheumatoid arthritis (JRA) consists of several distinct subsets. We describe 6 children (2 boys, 4 girls, mean age 3.7 years, range 2.0-4.9 years) with arthritis and eye involvement associated with infection with Chlamydia trachomatis. In some of the children, the clinical picture was similar to early onset pauciarticular JRA: onset within the first 4 years of life, predominance of girls, pauciarticular arthritis, subacute uveitis, and presence of antinuclear antibodies. Joint involvement was pauciarticular in 4 patients and polyarticular in 2. Two patients had clinical symptoms of Reiter's disease. Further investigations of this post chlamydial associated syndrome should be performed to establish appropriate diagnostic, therapeutic and prognostic measures.