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The British Journal of Rheumatology, Vol 36, 661-668, Copyright © 1997 by British Society for Rheumatology

ORIGINAL PAPERS

Mycoplasmal arthritis in patients with primary immunoglobulin deficiency: clinical features and outcome in 18 patients

A Franz, AD Webster, PM Furr and D Taylor-Robinson
Department of Clinical Immunology, Royal Free Hospital School of Medicine, London.

A survey of 358 patients with primary antibody deficiency shows that mycoplasmal infection is the commonest cause of severe chronic erosive arthritis. We review our experience with 18 patients with confirmed or probable mycoplasmal arthritis. There was a broad spectrum of severity from a monoarthritis rapidly responding to tetracyclines to severe debilitating polyarthritis, sometimes with antibiotic-resistant organisms which in two cases were eliminated following hyperimmune animal serum therapy. Most patients had very low serum 1gG levels at the onset of arthritis, suggesting that maintaining levels within the normal range with immunoglobulin replacement may prevent infection. The unique susceptibility of these patients to mycoplasmal arthritis shows that antibodies play a crucial role in protection against these organisms.
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