Reactive arthritis was formerly known as reiter syndrome disease, which is the combination of urethritis, arthritis and conjunctivitis. It is generally regarded as a form of spondyloarthritis. Acute rheumatic fever arf is the most well known arthritis accompanied with group a streptococcal gas. Third international workshop on reactive arthritis an overview ncbi. These cases may represent a reactive arthritis and should be distinguished from rheumatic fever, streptococcal septic arthritis, viral arthritides, acute rheumatic diseases such as juvenile chronic arthritis, and a monoarticular presentation of a seronegative spondyloarthropathy. Poststreptococcal reactive arthritis in japan sciencedirect. Many patients will get severe bloating, abdominal pain, and watery diarrhea. These images are a random sampling from a bing search on the term poststreptococcal reactive arthritis.
A reactive arthritis may develop after a person eats food that has been tainted with the pathogenic bacteria. Rea has been associated with gastrointestinal gi infections with shigella, salmonella, campylobacter, and other organisms, as well as with genitourinary gu infections especially with chlamydia trachomatis. Reactive arthritis rea is inflammatory arthritis which manifests after several days to weeks after a gastrointestinal or genitourinary infection. Reactive arthritis is not caused by an active infection within the joints and reactive arthritis eng dd 2 62711 8. In some cases the specific virus involved can be identified on the basis of the clinical features of. I saw my internist for a case of sudden onset polyarticular arthritis though mostly arthralgias that started about 8 days after onset of a febrile illness that included severe pharyngitis. Viral arthritis is inflammation of the joints from a viral infection. The age distribution was bimodal, with one peak in childhood and one peak in adulthood. Like acute rheumatic fever arf, psa is a reactive arthritis characterized by a pharyngeal streptococcal infection, a symptomfree interval and subsequent aseptic inflammation of one or more joints. As a result of improvements in the social economy, hygiene. Poststreptococcal reactive arthritis and the association. Psra commonly affects children between 8 to 14 years of age and young adults between 21 to 27 years. We report a case of poncets disease in a 20year old man whose reactive arthritis overshadowed other clinical symptoms of tb resulting in delayed diagnosis and treatment. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters.
To find out whether poststreptococcal reactive arthritis psra is a discrete, homogeneous clinical syndrome. The infection that causes reactive arthritis usually presents as diarrhoea or as a sexually transmitted disease. Although rheumatic fever itself would qualify for this definition, the concept became clinically associated with antecedent infections of the gastrointestinal gi and genitourinary gu tracts. Additionally, circinate balanitis is an inflammatory skin condition that forms around the penis in males affected by reactive arthritis.
Although no specific criteria exist for the diagnosis of reactive arthritis, it is often based clinically on the development of acute oligoarticular arthritis within 24 weeks of preceding infections. Reactive arthritis may occur during epidemics, particularly following gastrointestinal infections, and has a prevalence of 3040 cases per 100,000. There is an illness usually called post streptococcal reactive arthritis, meaning only arthritis is present following streptococcal infection. Damage to cardiac valves may be chronic and progressive, resulting in cardiac decompensation. Diagnosis of reactive arthritis is difficult due to vast. The patient was found to meet criteria for both acute rheumatic fever and post streptococcal reactive arthritis, leading to. Acute rheumatic fever arf and post streptococcal reactive arthritis psra are nonsuppurative complications of group a streptococcal gas pharyngitis. It is classified as a type of seronegative spondyloarthropathy.
In the canonical medical textbook of his day, sir william osler, md, a founder of modern medicine at mcgill, johns hopkins, and oxford universities, provided the following comment. Classically, these complications occur more often in children. Post streptococcal syndromes, a rheumatologist perspective. Dec 06, 2018 reactive arthritis rea, formerly known as reiter syndrome, is an autoimmune condition that develops in response to an infection. P oststreptococcal arthritis psa is a poorly understood clinical syndrome that has generated much controversy and for which clear diagnostic criteria and therapeutic recommendations are lacking. Polyarthritis following a streptococcal infection, a. Acute rheumatic fever arf is a nonsuppurative sequela that occurs two to four weeks following group a streptococcus gas pharyngitis and may consist of arthritis, carditis, chorea, erythema marginatum, and subcutaneous nodules. Click on the image or right click to open the source website in a new browser window. Reactive arthritis share this page data on the incidence and prevalence of rea are scarce, partly because of a lack of a disease definition and classification criteria. It is usually called reactive arthritis or post streptococcal reactive arthritis psra. Post streptococcus reactive arthritis is an acute nonsuppurative arthritis following a known. It usually develops after an infection, often in the bowel or genital areas. Reactive arthritis rea is an immunemediated seronegative arthritis that belongs to the group of spondyloarthropathies and develops after a gastrointestinal or genitourinary system infection.
One of the most frustrating things about reactive arthritis is the fact that so few ever have to go through it, and youll feel alone while suffering, desperate to learn about how others experience it. Reactive arthritis is a form of arthritis that occurs as a result of some bacterial infections. If differs from arthritis of acute rheumatic fever arf, which mainly involves large joints. Reactive arthritis is a condition which can develop following any infection usually a bowel or sexually transmitted infection, causing painful swelling of the joints. Reactive arthritis rea is a joint inflammation developing soon after or during an infection elsewhere in the body, but the organism cannot be isolated or cultured. However in some patients, the initial infection may be milder and not easily recognized, but the reactive arthritis may still occur. Reactive arthritis is a painful form of inflammatory arthritis joint disease due to inflammation. Reactive arthritis rea became operationally defined as a nonseptic arthritis that followed an extraarticular infection. Reactive arthritis is an uncommon disease that can make your joints hurt and swell. Acute rheumatic fever and post streptococcal reactive arthritis in adults can present in a similar manner. My experience of reactive arthritis lauras lovely blog. Reactive arthritis information booklet versus arthritis.
Reactive arthritisdefinition an arthritis that arises following an infection, although the pathogens cannot be cultured from the affected joints. Oct 20, 2011 there is a debate whether post streptococcal reactive arthritis psra is a separate entity or a condition on the spectrum of acute rheumatic fever arf. Reactive arthritis often affects men between 20 and 50. A strep culture was eventually positive and i was treated with 10 days of amoxicillin. Reactive arthritis in tuberculosis tb is known as poncets disease, a rare aseptic form of arthritis observed in patients with active tb. It usually develops within 10 days after a throat infection.
A 25 year old caucasian male developed a transient crippling polyarthritis one month following treatment of a sore throat. Poststreptococcal reactive arthritis psra is defined as inflammatory arthritis of. There is an illness usually called poststreptococcal reactive arthritis, meaning only arthritis is present following streptococcal infection. Reactive arthritis following foodborne illness reactive. Psra that does not meet the jones criteria for arf has also been reported. Differentation of poststreptococcal reactive arthritis from acute rheumatic fever. Get a printable copy pdf file of the complete article 5k. Reactive arthritis rea is a sterile inflammatory arthritis that follows an infection at a different site, commonly enteric or urogenital. Approximately 1% of all cases of acute arthritis are thought to have a viral etiology. It is usually called reactive arthritis or poststreptococcal reactive arthritis psra. Once called reiters syndrome, it is a spondyloarthropathy.
However, unlike arf, the risk of other postinfectious complications is not clear. Its usually short in duration, but can be chronic in some people. The annual incidence has been estimated to be 5 cases per 100,000 for gastrointestinal related reactive arthritis and 4. My joint pain continued so i was referred to a rheumatologist who diagnosed. To study the clinical presentation of poststreptococcal reactive arthritis psra and its periarticular manifestation. Reactive arthritis after gas infection poststreptococcal reactive arthritis. The classic presentation of rea is characterized by an. Pdf poststreptococcal reactive arthritis in children. In recent years, the view that arthritis has an infectious cause has been gaining ground, although as yet positive bacteriological evidence is lacking. Reactive arthritis american college of rheumatology.
In women, an infection in the vagina can cause the. Because up to 6% of psra patients develop mitral valve disease, it is recommended that antistreptococcal prophylaxis be administered for 1 year. Some patients with reactive arthritis have bouts of abdominal pain, and bowel lesions similar to that of inflammatory bowel disease are detected through a colonoscopy. Reactive arthritis bones, joints and muscles forums. Sometimes, reactive arthritis is set off by an infection in the bladder, or in the urethra, which carries urine out of the body. Those developing the illness experience pain, swelling and. Classical rea is triggered by two major types of bacterial infection, non specific urethritis due to chlamydia trachomatis. This may be part of the many clinical features of rheumatic fever.
Arthritis of one or more joints after group a strep pharyngitis. The infection causes activity in the immune system. Reactive arthritis bones, joints and muscles forums patient. What does a non reactive arthritis mean answers on healthtap. Some tests are essential for diagnosis and follow up. Nonethless, it is almost certainly not rheumatoid arthritis in children, but what is now called juvenile idiopathic arthritis. What you should know about reactive arthritis american. Aug 06, 2015 it means a lot, as this condition is quite rare. Cardiac involvement is the most serious manifestation of arf. The reaction is to an infection somewhere else in your body. Like acute rheumatic fever arf, psa is a reactive arthritis characterized by a pharyngeal streptococcal infection, a symptomfree interval and subsequent aseptic inflammation of one.
It occurs in reaction to an infection by certain bacteria. Doctor answers on symptoms, diagnosis, treatment, and more. Reactive arthritis is an inflammatory disease that occurs in reaction to infections by certain bacteria. The normal role of your bodys immune system is to fight off infections to keep you healthy. One type of infectious arthritis is reactive arthritis. This need not be crippling, and most can lead a perfectly normal life, including sports, with. As a result of improvements in the social economy, hygiene environment, and development of antimicrobial drugs, the number of these arthritis cases is decreasing. Poststreptococcal reactive arthritis disorder, poststreptococcal reactive arthritis. Rheumatic fever and poststreptococcal reactive arthritis. Find local reactive arthritis resources for the top u. Some cases of reactive arthritis are caused by the chlamydia trachomatis bacteria, which is a highly infectious sexually transmitted disease characterized by genital infections, rashes, and warts. Mar 28, 20 reactive arthritis or reiters syndrome is a painful form of inflammatory arthritis that develops in reaction to an infection by bacteria or virus by the time the patient presents with symptoms, oftentimes the trigger infection has been cured or is in remission in chronic cases 4. Apr 10, 2007 i saw my internist for a case of sudden onset polyarticular arthritis though mostly arthralgias that started about 8 days after onset of a febrile illness that included severe pharyngitis. The patient was found to meet criteria for both acute rheumatic fever and post streptococcal reactive arthritis, leading to the question of the role of antibiotic.
We show how the demographic, clinical, genetic and treatment characteristics of psra differ from. Reactive arthritis, formerly known as reiters syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body crossreactivity. Polyarthritis following a streptococcal infection, a doctors. Psra is not associated with hlab27 but rather with hladrb101.
Poststreptococcal reactive arthritis is a type of sterile arthritis which occurs after a betahemolytic streptococcal throat or skin infection. Reactive arthritis is a condition that causes inflammation, pain and swelling of the joints. Explore how a rash can be a clear indicator of this terrible condition, along with other skin problems, by reading more now. Poststreptococcal reactive arthritis and the association wit. Reactive arthritis is also sometimes called reiters syndrome, after a german army doctor in the first world war who first described the condition. Poststreptococcal reactive arthritis bentham science. May 01, 2020 one type of infectious arthritis is reactive arthritis. Because up to 6% of psra patients develop mitral valve disease, it is recommended that antistreptococcal prophylaxis be administered for 1 year and then discontinued. Juvenile reactive arthritis tends to last for 6 weeks. Nov 12, 2019 viral arthritis is inflammation of the joints from a viral infection. Reactive arthritis was initially used to describe the development of sterile inflammatory arthritis as a sequel to remote infection. There is a debate whether poststreptococcal reactive arthritis psra is a separate entity or a condition on the spectrum of acute rheumatic fever arf. Reactive arthritis north carolina rheumatology association. Reactive arthritis reiter syndrome statpearls ncbi bookshelf.
Acute rheumatic fever arf and poststreptococcal reactive arthritis psra are nonsuppurative complications of group a streptococcal gas pharyngitis. Friedlander on what does a non reactive arthritis mean. Unlike rheumatoid arthritis or osteoarthritis, reactive arthritis is usually a shortlived condition that lasts for less than 6 months and, in most cases, disappears completely leaving no problems. It can also cause rash, fever, weight loss, heart problems, red eyes and blurry vision. Infection from a broad range of viruses can result in arthralgias and arthritis. Reactive arthritis rea, formerly known as reiter syndrome, is an autoimmune condition that develops in response to an infection. May represent mild form of rheumatic fever or separate entity.