Rheumatoid Arthritis, Kartagener’s Syndrome, and Hyperprolactinemia: Who Started It?

Abstract

We report a case of an 18-year-old girl who presented to our hospital with history of recurrent respiratory infections, amenorrhea, and symmetric polyarthritis. She was diagnosed with rheumatoid arthritis (RA), Kartagener's syndrome (KS), and hyperprolactinemia. There have been very few case reports in the literature of RA occurring in the setting of KS, theoretically proposed to be due to chronic stimulation of the immune system by recurrent infections. Furthermore, hyperprolactinemia has been hypothesized to mirror RA disease activity and case reports of treatment with dopamine agonists have led to the speculation of whether or not they represent a new line of experimental treatment in the future. Our patient was found to have both KS and hyperprolactinemia together in the setting of RA, and based on our literature search, this is the first reported case of such a combination. This strikes a very intriguing question: are these three conditions interlinked by a yet to be defined association? And treatment of which condition leads to the resolution of the other?

Prolactin Hormone and Vasoinhibin in Rheumatoid Arthritis Patients

“…Vasoinhibin showed positive statistically significant correlation with VAS (p<0.05), while positive non-significant correlation was found with morning stiffness, disease duration (p >0.05). Similarly, to our results, Halabi et al, [27] revealed positive correlation between prolactin and number of tender and swollen joints. In agreement to our results, Haga et al, [28] found that there was no correlation of serum PRL to e VAS on a study included 307 RA patients .…”

Síndrome de Kartagener y artritis reumatoide. Reporte de caso

“…La presentación de SK y AR es poco frecuente y no hay evidencia disponible para sostener una relación de causalidad entre ambas enfermedades. Se han registrado algunos casos, entre ellos un adolescente de 11 años de edad, con diagnóstico de artritis idiopática juvenil y FR negativo que evolucionó con buena respuesta luego del tratamiento con metotrexato y prednisona; una mujer de 60 años de edad, diabética e hipertensa, con AR no erosiva, FR positivo, que se encontraba en remisión, debido a esto recibió fosfato de cloroquina y metilprednisolona; una mujer de 38 años con FR positivo, erosiva, en tratamiento con prednisona 7,5 mg al día y metotrexato 15 mg un día a la semana; un hombre de 35 años con FR positivo debido a una artritis erosiva que tuvo buena evolución con prednisona 10 mg diarios y metotrexato 15 mg cada semana; finalmente una adolescente de 18 años con AR no erosiva y FR negativo, que recibió metotrexato a 20 mg un día a la semana y prednisona 5 mg al día 9,12,13 .…”