Intestinal Clostridium Perfringens in Rheumatoid Arthritis and Other Collagen Diseases1

AbstractThe intestinal anaerobic flora has been studied, with special reference to Clostridium perfringens, in various collagen diseases, rheumatoid arthritis (R.A.) in particular, and in a series of control cases. The C. perfringens flora was qualitatively and quantitatively abnormal in two‐thirds of 186 R.A. cases, in two‐thirds of “entero‐arthritis” cases, in about half the S.L.E., the psoriatic‐arthritis, and the seronegative‐polyarthritis cases, but only in a few of the patients with pelvospondylitis ossificans and uro‐arthritis (Reiter's syndrome). An abnormal C. perfringens flora was not demonstrated in any of the patients with polyarthritis or arthralgia after tonsillitis, nor in any of the control cases. The alpha‐antitoxin titre in serum was raised in 78% of the R.A. cases, and such titre rises, which occurred parallel to the pathological C. perfringens flora, were also demonstrated in the cases of other inflammatory rheumatic diseases but were not noted in any of the control cases. The results of faeces cultures and serological examinations are analysed in relation to several clinical and laboratory parameters, such as the patient's age and sex, duration and activity of the disease, administered drugs, hypergammaglobulinaemia, and secretion of hydrochloric acid in the stomach. A tendency to higher frequency of abnormal C. perfringens flora is noted both in R.A. patients with high disease activity and in elderly patients.