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Exacerbation of rheumatoid arthritis following Helicobacter pylori eradication: disruption of established oral tolerance against heat shock protein?
- Source :
- Medical hypotheses. 64(1)
- Publication Year :
- 2004
-
Abstract
- A 62-year-old Japanese woman with RA received an eradication therapy against Helicobacter pylori in November 1999. Eight weeks later, successful eradication was confirmed by negative results for rapid urease test, pathologic findings, and a fall in anti-H. pylori IgG antibody titer. During the course, parameters for RA activity were exacerbated: C-reactive protein 1.1-4.2 mg/dL, rheumatoid arthritis precipitation antigen 2560-5120 dils., erythrocyte sedimentation rate 52-123 mm/h, and complements CH50 50 to over 60 U/mL. Lansbury index increased from 70% to 105%. Two more weeks later, the patient noticed right shoulder pain. She also complained of bilateral gonalgia two months later, and physical examination revealed increased fluid in the knee joints. Prednisolone was required to control the disease activity. The results of this case suggested that RA patients might experience a deleterious effect on the disease activity following H. pylori eradication possibly through disruption of the established oral tolerance against stress protein such as mycobacterial heat shock protein 65.
- Subjects :
- Exacerbation
Chaperonins
Rapid urease test
Arthritis
Administration, Oral
Arthritis, Reactive
Severity of Illness Index
Helicobacter Infections
Arthritis, Rheumatoid
Bacterial Proteins
medicine
Humans
medicine.diagnostic_test
biology
Helicobacter pylori
business.industry
Antibody titer
Models, Immunological
General Medicine
Chaperonin 60
Drug Tolerance
Middle Aged
medicine.disease
biology.organism_classification
Anti-Bacterial Agents
Erythrocyte sedimentation rate
Rheumatoid arthritis
Immunology
Prednisolone
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 03069877
- Volume :
- 64
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Medical hypotheses
- Accession number :
- edsair.doi.dedup.....31a8b12088b6fc03724afa4d0cb32e0c