Meningococcal arthritis. Clinical presentation and serologic characteristics in 13 patients
Merino, J.; Rodríguez-Valverde, V.; González-Gay, M.A.; Calderón, J.; Casanueva, B.
Medicina Clinica 86(19): 788-790
1986
ISSN/ISBN: 0025-7753 PMID: 3736184 Document Number: 281747
Thirteen patients developing arthritis during acute meningococcal infection were analyzed. In 7 cases arthritis developed early (group I) whereas in the 6 remaining patients in developed later (between the 7th and 10th day of evolution) (group II). Arthritis was monoarticular in 9 cases and oligoarticular in the remaining 4; knees, ankles and wrists were the most common localizations. Arthritis had a longer duration in group II (15.2 .+-. 5.7 days versus 6.4 .+-. 2.6 days); in this group non-steroidal antiinflammatory drugs had to be used. In all cases normal articular function was completely recovered. In 5 patients in each group the levels of circulating immunocomplexes (CIC) were determined by radioimmunoassay with Raji cells and fixation to C1q in solid phase; concentrations of C3 and C4 complement factors were measured by nephelometry. All determinations were made during the acute phase and during convalescence. In no case from group I CIC were found, whereas in group II abnormal levels (although not strikingly high) were found during the acute phase in two patients and in three out of the four sera where the measurement was made during arthritis. C3 and C4 levels were always normal except in one patient with diseminated intravascular coagulation. In view of the low and inconstant CIC levels in late-onset meningococcal arthritis, our data do not support the hypothesis that this condition is secondary to articular CIC deposition. This does not rule out the in situ formation of immunocomplexes as the responsible mechanism of this late form of articular involvement.