Coxsackievirus and adenovirus infection. Association with acute febrile and juvenile rheumatoid arthritis

Abstract

The prearthritic manifestations of juvenile rheumatoid arthritis in a 16 yr old boy were associated with a rise in coxsackievirus B3 and A9 neutralizing antibody titers from 1:16 to .gtoreq. 1:512, and 1:64 to 1:512, respectively. Recurrent polyarthritis followed and persisted for 3 years. Adenovirus 7 was isolated from the pericardial fluid of a 9 yr old girl in whom juvenile rheumatoid arthritis then developed. Of 11 patients with acute, nonspecific febrile arthritis subsequently studied, .gtoreq. 4-fold antibody elevations occurred against coxsackieviruses in 5, and against rubella and varicella-zoster virus in 2. Antibody titers against other viral (and Mycoplasma) antigens remained stable. Coxsackieviruses and other common viruses may cause acute, nonspecific febrile arthritis. In certain instances, such infection may be related to the development of juvenile rheumatoid arthritis.