Reactive arthritis

Abstract

Reactive arthritis (ReA) can be defined as the development of sterile inflammatory arthritis as a sequel to remote infection, often in the gastrointestinal or urogenital tract. Although no generally agreed-upon diagnostic criteria exist, the diagnosis is mainly clinical, and based on acute oligoarticular arthritis of larger joints developing within 2-4 weeks of the preceding infection. According to population-based studies, the annual incidence of ReA is 0.6-27/100,000. In addition to the typical clinical picture, the diagnosis of ReA relies on the diagnosis of the triggering infection. Human leucocyte antigen (HLA)-B27 should not be used as a diagnostic tool for a diagnosis of acute ReA. In the case of established ReA, prolonged treatment of Chlamydia-induced ReA may be of benefit, not only in the case of acute ReA but also in those with chronic ReA or spondylarthropathy with evidence of persisting chlamydia antigens in the body. In other forms of ReA, there is no confirmed evidence in favour of antibiotic therapy to shorten the duration of acute arthritis. The outcome and prognosis of ReA are best known for enteric ReA, whereas studies dealing with the long-term outcome of ReA attributable to Chlamydia trachomatis are lacking.

Proinflammatory S100 proteins as clinical markers of juvenile idiopathic arthritis

“…Components of triggering bacteria including nucleic acids and proteins have been identified in the synovium and in circulatory monocytes of patients with rheumatoid arthritis (25). Clinically, the duration of reactive arthritis for more than 6 months is already the sign of development of chronicity (31). But at the early stage of disease, according to our data, high calprotectin level in acute arthritis could be associated with JIA development despite of detected infectious markers at the early stage of disease.…”

Reactive Arthritis Caused by Urinary Tract Infection

“…The most common enteric bacterial pathogens are Yersinia, Salmonella, Shigella, Campylobacter, and Clostridium difficile. Other pathogens reported to cause the development of ReA include Chlamydophilia pneumoniae (1). In patients with bladder cancer, intravesical Bacillus Calmette-Guerin (BCG) treatment has also been reported to be a rare cause of ReA (3).…”

“…ReA is an uncommon inflammatory joint disorder that typically occurs in young adults (1). Although urogenital infection by Chlamydia trachomatis is commonly associated with ReA (2), Escherichia coli (E. coli) and/or Enterococcus faecalis urinary tract infections (UTIs) are conditions that very rarely cause ReA.…”

Reactive arthritis: can't see, can't pee, can't climb a tree…

“…The incidence has been estimated to be in the region of 0.6-27:100 000 in Scandinavia, where most of the studies on reactive arthritis have been carried out. 3 Similar to the aetiology of other spondyloarthropathies, 75% of patients are HLA-B27 positive. 4 There is a preponderance towards the male sex and those of Caucasian origin, between the ages of 20-40 years old.…”