Juvenile onset psoriatic arthritis in a patient with X-linked agammaglobulinemia (Bruton's disease)

We describe a 47-year-old male patient suffering from X-linked (or Bruton's) agammaglobulinemia with severe psoriatic arthritis (PsA), which started in childhood. PsA has been previously described in T-cell defective disorders, such as HIV infection, but our observation demonstrates that this rheumatic disease can also occur in subjects with B-lymphocyte cell functional impairment. Chronic inflammatory (bacterial?) involvement of the bowel could represent a pathogenetic connection between X-linked agammaglobulinemia and PsA.