J Rheum Dis.  2012 Apr;19(2):95-99. 10.4078/jrd.2012.19.2.95.

A Case of Rheumatoid Arthritis in a Patient with Bruton-Type Agammaglobulinemia

• Park DJ
• Lee SJ
• Kim TJ
• Park YW
• Bae E
• Kang ES
• Lee SS

• KMID: 2223107
• DOI: http://doi.org/10.4078/jrd.2012.19.2.95

Abstract

Bruton-type agammaglobulinemia is primary hypogammaglobulinemia followed by severe recurrent infection, including bacterial otitis media, bronchitis, pneumonia, and meningitis. Septic arthritis is a main musculoskeletal disorder that can occur in association with Bruton-type agammaglobulinemia. But the development of rheumatoid arthritis (RA) is rarely reported in a patient with hypogammaglobulinemia. Here, we describe a case of 34-year-old male with Bruton-type agammaglobulinemia, who presented with multiple symmetric polyarthritis. He was diagnosed as having a RA according to ACR criteria. His symptoms of polyarthritis had been improved after the introduction of medications including DMARDs (disease modifying anti-rheumatic drugs). Our case suggests that RA can be developed in the setting of agammaglobulinemia, and even in this situation, anti-rheumatic agents were effective to control arthritis without complication such as severe infection.

Keyword

Bruton-type agammaglobulinemia; Rheumatoid arthritis; Anti-rheumatic agents

MeSH Terms

Adult
Agammaglobulinemia
Antirheumatic Agents
Arthritis
Arthritis, Infectious
Arthritis, Rheumatoid
Bronchitis
Genetic Diseases, X-Linked
Humans
Male
Meningitis
Otitis Media
Pneumonia
Agammaglobulinemia
Antirheumatic Agents
Genetic Diseases, X-Linked

Figure

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  Figure 1 Ultrasonography of right wrist showed tenosynovitis (arrow) of extensor digitorum tendon (A), synovial hypertrophy (arrows) of right wrist joint (B) and left wrist joint (C), and joint effusion and synovial hypertrophy (arrow) of IP joint of right thumb (D).

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  Figure 2 F/U ultrasonography of both wrists still showed synovial hypertrophy (arrows) of right wrist joint (A) and left wrist joint (B), and also synovial hypertrophy (arrow) showed in left 5th MCP joint (C).

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