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Article in Japanese

A case of reactive arthritis after Chamydophila pneumoniae infection with juvenile idiopathic arthritis-like symptoms

Haruka NODA1), Yoshihiko KAWANO1), Natsuki NAKAMURA1), Shinya HARA1)

This study reported a case of reactive arthritis (ReA) triggered by Chlamydophila pnuemoniae infection with juvenile idiopathic arthritis (JIA)-like symptoms, which was diagnosed ultimately by examination results and clinical course. A 5-years-old boy was admitted to this hospital with fever and difficulty in movement due to polyarthralgia. His test results showed leukocytosis and an elevated C-reactive protein (CRP) value. Magnetic resonance imaging (MRI) showed synovitis in multiple joints. Severe polyarthralgia persisted and rash appeared on his extremities on day 6. While JIA-like symptoms were observed, the presence of high titer of serum IgM against C. pnuemoniae was revealed in examination at admission. The patient had suspected ReA following C. pnuemoniae infection. The pain was improved remarkably after nonsteroidal anti-inflammatory drugs (NSAIDs) were administered. ReA is triggered by enteric infections and features mild mono- or oligo-arthritis that occurs frequently in the lower limb. C. pneumoniae triggered ReA has been reported, but it is not well known. Because JIA and ReA have different pharmacologic therapy and complications, it is important to diagnose ReA in order to identify the causative bacteria.

1) Department of Pediatrics, TOYOTA Memorial hospital

Key words reactive arthritis, Chlamydophila pneumoniae, juvenile idiopathic arthritis
Received December 27, 2019
Accepted April 20, 2020

32 (3):208─214,2020