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Related Experiment Videos

Relapsing Clostridium difficile colitis and Reiter's syndrome.

R S Hayward1, R H Wensel, P Kibsey

  • 1Department of Medicine, University of Alberta, Edmonton, Canada.

The American Journal of Gastroenterology
|June 1, 1990
PubMed
Summary

Clostridium difficile infection can trigger Reiter's syndrome, characterized by arthritis and urethritis, in susceptible individuals. This case suggests C. difficile toxins are not directly responsible for the joint inflammation.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Recurrent Clostridium difficile-associated colitis can present with extraintestinal manifestations.
  • Reiter's syndrome, a reactive arthritis, is associated with HLA-B27 positivity.

Observation:

  • A patient with recurrent C. difficile colitis experienced severe arthritis and urethritis with each episode.
  • Immune complexes were found in synovial fluid, but antibodies to C. difficile toxins were absent.
  • The patient was HLA-B27 positive and developed symptoms including sacroiliitis, tenosynovitis, and oligoarthritis.

Findings:

  • Symptoms resolved with successful treatment of C. difficile colitis, indicating a strong temporal link.
  • The patient's presentation suggests C. difficile infection may precipitate Reiter's syndrome.

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  • Evidence does not support a role for antibodies to C. difficile toxins in the joint inflammation.
  • Implications:

    • This case supports the hypothesis that C. difficile infection can trigger Reiter's syndrome.
    • Further research is needed to elucidate the mechanisms linking C. difficile infection to reactive arthritis.
    • Understanding this association may lead to improved diagnostic and therapeutic strategies for patients with recurrent C. difficile and reactive arthritis.