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Park, Lee, Kim, Park, Bae, Kang, and Lee: A Case of Rheumatoid Arthritis in a Patient with Bruton-Type Agammaglobulinemia
Case Report
Journal of Rheumatic Diseases

Journal of Rheumatic Diseases 2012; 19(2): 95-99.

Published online: 30 April 2012

DOI: https://doi.org/10.4078/jrd.2012.19.2.95

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

Dong-Jin Park1, Sung-Ji Lee1, Tae-Jong Kim1, Yong-Wook Park1, Eunsin Bae2, Eun-Suk Kang2, Shin-Seok Lee1

1Department of Rheumatology, Chonnam National University Medical School, Gwangju, Korea.

2Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding to: Shin-Seok Lee, Department of Rheumatology, Chonnam National University Medical School, 5, Hak-dong, Dong-gu, Gwangju 501-746, Korea. shinseok@chonnam.ac.kr

Received 13 July 2011       Revised 5 September 2011       Accepted 6 September 2011

Copyright © 2012 by The Korean College of Rheumatology

(free-access):

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Bruton-type agammaglobulinemia, Rheumatoid arthritis, Anti-rheumatic agents

Figures and Tables

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).
jrd-19-95-g001
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).
jrd-19-95-g002

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