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X-linked agammaglobulinemia combined with juvenile idiopathic arthritis and invasive Klebsiella pneumoniae polyarticular septic arthritis

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Abstract

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disease caused by mutations in the Bruton’s tyrosine kinase (BTK) gene. XLA can also present in combination with juvenile idiopathic arthritis (JIA), the major chronic rheumatologic disease in children. We report herein the first known case of a juvenile patient diagnosed with XLA combined with JIA that later developed into invasive Klebsiella pneumoniae polyarticular septic polyarthritis. An additional comprehensive review of XLA combined with JIA and invasive K. pneumoniae septic arthritis is also presented. XLA was identified by the detection of BTK mutations while the diagnosis of JIA was established by clinical and laboratory assessments. Septic arthritis caused by invasive K. pneumoniae was confirmed by culturing of the synovia and gene detection of the isolates. Invasive K. pneumoniae infections can not only result in liver abscesses but also septic arthritis, although this is rare. XLA combined with JIA may contribute to invasive K. pneumoniae infection.

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All authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Rheumatology, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014, Zhejiang, China

    Zaihua Zhu, Yanjing Huang & Yasong Li

  2. Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China

    Yuli Kang

  3. Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Zhenlang Lin

  4. Clinical laboratory, Zhejiang Provincial People’s Hospital, Hangzhou, China

    Huoyang Lv

Authors
  1. Zaihua Zhu
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  2. Yuli Kang
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  3. Zhenlang Lin
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  4. Yanjing Huang
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  5. Huoyang Lv
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  6. Yasong Li
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Corresponding author

Correspondence to Yasong Li.

Additional information

Zaihua Zhu, and Yuli Kang contributed equally to this work.

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Zhu, Z., Kang, Y., Lin, Z. et al. X-linked agammaglobulinemia combined with juvenile idiopathic arthritis and invasive Klebsiella pneumoniae polyarticular septic arthritis. Clin Rheumatol 34, 397–401 (2015). https://doi.org/10.1007/s10067-014-2537-y

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  • DOI: https://doi.org/10.1007/s10067-014-2537-y

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