Intestinal Clostridium Perfringens in Rheumatoid Arthritis and Other Connective Tissue Disorders)Studies of Fecal Flora, Serum Antitoxin Levels and Skin Hypersensitivity

Abstract

Summary The intestinal anaerobic flora has been studied, with special reference to the presence of C. perfringens, in various collagen diseases and in a series of control cases. Two thirds of the patients with rheumatoid arthritis and about half of those with systemic lupus erythematosus and psoriatic arthropathy showed an abnormally high fecal flora of atypical C. perfringens. Up to now, this bacterial type has not been demonstrated in a control series of 70 cases, whereas it has been isolated in a few cases of postinfectious joint disorders and ankylosing spondylitis. There was a rise of the Clostridium perfringens alpha-antitoxin titer in 75 per cent of the rheumatoid arthritis patients, but no such rise was noted in the control subjects. Evidence of delayed cutaneous hypersensitivity to a purified C. perfringens alpha-toxin was seen in virtually all the rheumatoid arthritis cases and in 7 out of 10 SLE cases. Weakly positive skin reactions were obtained in only 4 out of 52 control cases.