Terapevt Arkh
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Altogether 52 children suffering from reactive arthritis were placed under observation. In 45 patients arthritis developed after nasopharyngeal infection and was marked by a favourable course with a rapid positive dynamics. 7 children with a history of intestinal infection manifested Reiter's syndrome; in these children arthritis was characterized by a grave and prolonged course and by a high laboratory activity. HLA A10 (RR = 2.7), B27 (RR = 2.5) and DR2 (RR = 2.19) antigen were detected significantly more frequently in ReA patients who suffered nasopharyngeal infection. In children with Reiter's syndrome, the genetic markers of predisposition to the disease were HLA A10 (RR = 5.93) and B27 (RR = 149.1) antigens.
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The paper is concerned with the results of studying the concentration of circulating immune complexes and immune system (the number of lymphocyte populations and subpopulations in the peripheral blood, the level of serum immunoglobulins) in 45 patients aged 10 to 72 years with hemorrhagic vasculitis depending on the disease pattern and course before and after the treatment. The patients suffering from hemorrhagic vasculitis manifested appreciable changes in humoral immunity and negligible derangement of cellular immunity associated with dramatic enhancement of complex formation. The intensity of the alterations was discovered to be dependent on the pattern and course of the disease.
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Local antirheumatic therapy is viewed as an important component in the total system of the treatment of rheumatic diseases. Drug-induced synovectomy, local anti-inflammatory, antifibrotic and potential immunosuppressive therapy are analyzed. ⋯ There is possibility to improve the results of general therapy at the expense of goal-oriented local treatment without producing any influence on its tolerance. In fact, every patient with rheumatoid arthritis or other articular disease should be regarded as a potential candidate for local anti-inflammatory therapy.