Campylobacter ileocolitis: an inflammatory bowel disease.
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Biomedical subjects
Publications and source records attributed to J R Lambert.
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Nitroblue tetrazolium test scores were obtained in 43 patients with psoriatic arthritis, 32 patients with rheumatoid arthritis, and 16 patients with osteoarthrosis. The mean score in all groups was similar and was higher than previously reported in patients awaiting heart surgery or with noninfective dermatoses. The test is not thought to be helpful in differentiating psoriatic arthritis from rheumatoid arthritis, and its usefulness in the diagnosis of septic arthritis superimposed on other forms of arthropathy is limited.
Positive tests for anti-nuclear factor were found in 7% of 101 patients with psoriatic arthritis. In only one case was this at a significantly high titre. The overall prevalence is that expected in the community, though there was a high prevalence in those with Sjögren's syndrome. This is a further differentiating feature from rheumatoid arthritis.
Serum uric acid levels were determined in patients with psoriatic arthritis on and off medication, with rheumatoid arthritis on no medication likely to alter serum values, and in patients with uncomplicated psoriasis. Values in males were higher than those in females. A larger prevalence of values above the normal range were seen in males with psoriatic arthritis on uncontrolled medication (13-5%) and in males with rheumatoid arthritis (12%) than in the other groups. The means for both these groups were around the midpoints of the normal range. These findings suggest that hyperuricaemia is not a common characteristic of psoriatic arthritis.
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In a study of 112 patients (49 men, 63 women) with psoriatic arthritis, ocular inflammation was noted in 35 (31.2%). Conjunctivitis was the most common lesion, being found in 19.6% (10 males, 12 females). Iritis occurred in 7.1% (5 men, 3 women), episcleritis in 1.8% (1 man, 1 woman), and keratoconjunctivitis sicca in 2.7% (3 women). 20 patients (10 men, 10 women) had radiological sacroiliitis and 11 of these (7 men, 4 women) had ankylosing spondylitis according to the New York criteria. Eye lesions were noted in 7 of the patients with sacroiliitis, 3 having iritis (15%) and 4 (20%) conjunctivitis. 2 patients with spondylitis had iritis (18%) and 1 (9%) conjunctivitis. It is concluded that inflammatory eye lesions are a frequent accompaniment to psoriatic arthritis. This is taken as further evidence for the concept of the seronegative spondyloarthritides.
Histocompatibility (HL-A) antigen typing was performed on 82 patients with psoriatic arthritis. The prevalance of HL-AB27 was increased (28%) compared with that in a control group (7-5%), and this was most marked in those with spinal changes. The prevalence in patients with sacroiliitis and syndesmophytes was 75%, with sacroiliitis alone 78%, but with syndesmophytes and normal sacroiliac joints only 36%. The overall prevalence in psoriatic spondylitis was 60%, with a prevalence of 71% in those fulfilling the New York criteria for anklosing spondylitis. The prevalence was not increased in those with only peripheral arthritis (11%). The prevalence of HLA-B13 was decreased in those with psoriatic spondylitis, though this was not statistically significant. The overall prevalence of HLA-BW17 was increased, this being particularly so in those with syndesmophytes, but values were not significant.
Twenty-five Helicobacter pylori positive and 25 H. pylori negative subjects as defined by culture and phase contrast microscopy of antral biopsy specimens obtained from routine upper endoscopy were studied. Antral biopsies were examined by rapid urease test, phase contrast microscopy, culture and histology. Venous blood was tested for H. pylori specific IgG antibodies by an ELISA technique. Within 7 days of endoscopy the patients also had a [14C]-urea breath test. The sensitivity and specificity of the rapid urease test was 92%, the breath test 96% and 100%, histopathology 96% and 91% and serology 96% and 88%, respectively. The [14C]-urea breath test performed over 1 h with sampling of subjects at 0, 0.5 and 1 h was an accurate and reliable method. Results expressed as counts per minute of the expired 14CO2 proved to be a simple method of assessing H. pylori status. A significant correlation between severity of histological antral gastritis and the amount of 14CO2 expired was observed. This study has shown that the non-invasive 14C-urea breath test and serology are highly sensitive and specific for the diagnosis of H. pylori infection.