JAMA : the journal of the American Medical Association
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Four non-Chinese patients, middle-aged or older, developed agranuloctyosis while taking Chinese herbal medicines for relief of arthritis and back pain. All four developed life-threatening infections with bacterial sepsis; one died. The herbal medicines were shown to contain substantial amounts of undeclared aminopyrine and phenylbutazone, drugs that are well-known causes of agranulocytosis. These Chinese herbal medicines are widely available over the counter throughout the United States.
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The histocompatibility antigen W27 has been found to have a high incidence in ankylosing spondylitis (96%), Reiter syndrome (74%), and other forms of arthritis that may involve the axial skeleton. In patients with Reiter syndrome, there was no correlation between the presence of W27 antigen and the extent or duration of the symptoms. Sacroiliitis was predominantly found in those patients with W27 antigen in all the axial arthropathies. Tissue-typing techniques may be of value in detecting early or atypical disease.