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

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.