RESUMO
A patient with rheumatoid arthritis taking prednisone developed Blastocystis hominis acute diarrhoea, which was associated with increased inflammation and effusion of the left knee. B. hominis organisms were found in synovial fluid from the left knee. The patient responded dramatically to metronidazole treatment. B. hominis may become disseminated in immunosuppressed patients with diarrhoea and may cause infective arthritis. (AU)
Assuntos
Humanos , Adulto , Feminino , Artrite Infecciosa/complicações , Artrite Reumatoide/complicações , Enteropatias Parasitárias/complicações , Infecções por Protozoários/complicações , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/parasitologia , Enteropatias Parasitárias/tratamento farmacológico , Articulação do Joelho/parasitologia , Metronidazol/uso terapêutico , Infecções por Protozoários/tratamento farmacológico , Infecções por Protozoários/parasitologia , Líquido Sinovial/parasitologiaRESUMO
Arthritis in association with sickle cell disease was seen in 37 patients in a 21/2-year period. Cases of gout and of avascular necrosis of the femoral head were excluded. In 12 patients a non-inflammatory effusion occurred during the course of a painful crisis, in 12 patients an ankle effusion occurred in association with spontaneous development or deterioration of leg ulceration and in 13 patients there was a group of miscellaneous arthritides. Ankle arthritis with leg ulceration has not been previously recognised and its association with spontaneous ulceration, which is presumed to have a vaso-occlusive origin, is compatible with ischaemic synovial damage. The aetiology may therefore be similar to that believed to account for effusions in association with the painful crisis. (AU)