Detection of chlamydia trachomatis in arthritis affected female patients with cervicitis

Abstract EN

A role for infective agents in the etiology of inflammatory arthritis has been suspected for many years.

At present, there is neither a diagnostic test nor a specific treatment for reactive arthritis.

Aim of Work: To search for Chlamydia trachomatis in synovial fluids as a triggering agent for induction of arthritis.

Materials & Methods: This study was carried out on twenty-five female patients who complained of genital discharge and arthritis with knee effusion.

The diagnosis was reactive arthritis as a result of cervicitis.

Serum and synovial fluid samples underwent specific tests for detection of the serum specific antichlamydia antibody titer using the immunofluorecence technique (MIF) and detection of synovial specific chlamydial DNA with polymerase chain reaction (PCR).

Results: Laboratory investigations were within normal except the high ESR.

Positive serum specific antichlamydia trachomatis antibodies were detected in different serum dilutions of 14 out of 25 patients (56%).

From those patients, Chlamydia trachomatis DNA was isolated with PCR from synovial fluids of 6 patients (42.9%) representing 24% of the whole group.

It was found that Chlamydia trachomatis DNA could be isolated from the synovial fluid of patients with serum specific antichlamydia antibody titer 1/448 or above.

Significant correlations were recorded between joint affection, positive serum specific antichlamydia antibody titer, positive (MIF) and the presence of synovial Chlamydia trachomatis DNA, whereas the age and duration of the disease showed insignificant correlation with the same previous investigations.

Conclusion: Chlamydia arthritis should be considered in female patients suffering of cervicitis, where serum specific antichlamydia antibody titer is 1/448 or higher, until proved otherwise.

PCR has been a major advance in the diagnostic repertoires of arthritis.

It might become a standard diagnostic tool in reactive arthritis