Reiter's syndrome associated with HLA-B51

A 22-year-old Japanese man developed polyarthritis with fever and urethriti s, He was diagnosed as Reiter's syndrome since he was found to have uveitis and persistent aseptic pyuria, Although, he was negative for HLA-B27 or an y other HLA-B27 cross-reactive MHC class I antigens, he was positive for HL A-B51. The laboratory examination showed significant elevation of serum IgG and IgA anti-Chlamydia antibodies. He was successfully treated with a comb ination of doxycycline, naproxen, salazosulfapyridine and methotrexate with a decrease in IgG and IgA anti-Chlamydia antibodies. Previous studies prov ided evidence that HLA-B51 itself might be involved in the development of B ehcet's disease, which shares common features with Reiter's syndrome, such as uveitis, skin lesions, and polyarthritis, It is therefore suggested that combination of Chlamydia infection and HLA-B51 might play a role in the pa thogenesis of Reiter's syndrome in our patient.