Effect of an anti-histamine in rheumatoid arthritis.

In a recent article Levy (1951) records the treatment with an anti-histamine (Phenergan) of a small number of cases of infective arthritis and arthritis in Reiter's disease treated in a military hospital in Singapore. In his series of seven cases, six had a recent previous history of purulent urethritis, one having pyuria in addition, and the seventh had a recent previous history of bacillary dysentery and had developed the classical symptoms of Reiter's disease. Clinical improvement in the joints appeared in all cases in 7 days on a dosage of 150 mg. Phenergan daily, and all cases eventually returned to duty. Four of the patients had erythrocyte sedimentation rates varying from 46 to 97 mm. in one hour, and these all returned to normal at intervals varying from 21 days upwards. Broadly speaking, these cases had one aetiological factor in common, namely, a recent or present frank bacterial infection. This factor does not obtain in the aetiology of rheumatoid arthritis, but in view of the uniformly satisfactory results in these cases it was considered that the effect of Phenergan should be ascertained.