LESIONS OF THE MUSCULOSKELETAL SYSTEMIN CHRONIC BRUCELLOSIS. RESULTS OF OWN RESEARCH

Abstract

Introduction: Brucellosis is a particularly dangerous infection that can mimic various autoimmune multisystem diseases.
Osteoarticular manifestations of chronic brucellosis (ChB), such as spondylitis, sacroiliitis, back pain, arthritis, bursitis, and
tendinitis, make it difficult to timely diagnose with other clinically similar rheumatological diseases.
Objective: to study musculoskeletal disorders (MSD) symptoms in patients with chronic brucellosis to increase
awareness among physicians.
Results: We analyzed the medical history of 156 ChB patients with MSD. The average age of patients with ChB was
51.6±13.4 years (max 81, min 17). ChB was not associated with living in rural areas, nor with a specific ethnic group. 136 (87.2%) patients had a positive epidemiological history: the alimentary route of infection was detected in 122 patients and the
contact route in 14 patients. Back pain was registered in 58.3% of patients. Sacroiliitis confirmed by MRI was diagnosed in
19 out of 68 examined patients (27.9%). A positive ELISA result for the detection of antibodies to Brucella spp. IgG and IgA
were detected in 60.8% and 23.7% of patients, respectively. Wright and Huddleson's results were positive in 30.1% and
54.8% of patients, respectively. Positive RF and Anti-cyclic citrullinated peptide antibodies (ACCP) were detected in 22.4%
and 10% of patients. The HLA-B27 antigen was found in 9 (23%) of 39 patients with ChB.
Conclusions: The polymorphism of clinical manifestations and laboratory and instrumental results made clear the need
for differential diagnosis of ChB with rheumatoid arthritis (RA) and seronegative spondylitis (SpA). In the course of this study,
we found reference points that will help the doctor determine the algorithm of action to verify the correct diagnosis and timely
treatment.