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Current Rheumatology Reviews

Editor-in-Chief

ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Review Article

Post-Streptococcal Reactive Arthritis

Author(s): Yasser Bawazir*, Tanveer Towheed and Tassos Anastassiades

Volume 16, Issue 1, 2020

Page: [2 - 8] Pages: 7

DOI: 10.2174/1573397115666190808110337

Price: $65

Abstract

Introduction: Post-Streptococcal Reactive Arthritis (PSRA) is defined as inflammatory arthritis of ≥1 joint associated with a recent group A streptococcal infection in a patient who does not fulfill the Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF).

Methods: In this narrative review, we conducted a systematic search on MEDLINE, EMBASE, Cochrane Library and Google Scholar using the words poststreptococcal reactive arthritis. The search covered the time period between 1982 and 2016. The purpose of this review is to summarize the current state of knowledge of PSRA with respect to the definition, epidemiology, clinical presentation and treatment. We also summarize the key differences between PSRA, reactive arthritis (ReA) and ARF.

Results: PSRA has a bimodal age distribution at ages 8-14 and 21-37 years with an almost equal male to female ratio. Clinically, it causes acute asymmetrical non-migratory polyarthritis, however, tenosynovitis and small joint arthritis may occur. This disease entity can be associated with extraarticular manifestations, including erythema nodosum, uveitis and glomerulonephritis. The frequency of HLA-B27 in PSRA does not differ from that of the normal population, which suggests that it is a separate entity from ReA. Involvement of the axial skeleton, including sacroiliitis, is uncommon in PSRA. PSRA tends to occur within 10 days of a group A streptococcal infection, as opposed to the 2 to 3 weeks delay for ARF. PSRA can be associated with prolonged or recurrent arthritis, in contrast to ARF, in which arthritis usually lasts a few days to 3 weeks. Treatment usually involves NSAIDs or corticosteroids.

Conclusion: We summarize clinical features that help differentiate PSRA from ARF and ReA. First-line treatment options include NSAIDs and corticosteroids. Most cases resolve spontaneously within a few weeks, but some cases are recurrent or prolonged. There are no published randomized controlled trials of PSRA.

Keywords: Post-streptococcal reactive arthritis, acute rheumatic fever, reactive arthritis, streptococcal organism, diagnostic criteria, corticosteroids.

« Previous
[1]
Barash J, Mashiach E, Navon-Elkan P, et al. Pediatric Rheumatology study group of Israel. Differentiation of post-streptococcal reactive arthritis from acute rheumatic fever. J Pediatr 2008; 153(5): 696-9.
[http://dx.doi.org/10.1016/j.jpeds.2008.05.044] [PMID: 18657830]
[2]
Arnold MH, Tyndall A. Poststreptococcal reactive arthritis. Ann Rheum Dis 1989; 48(8): 686-8.
[http://dx.doi.org/10.1136/ard.48.8.686] [PMID: 2675783]
[3]
Goldsmith HJ, Ahmad R, Raichura N, et al. Association between rising haemoglobin concentration and renal cyst formation in patients on long term regular haemodialysis treatment. Proc Eur Dial Transplant Assoc 1983; 19: 313-8.
[PMID: 6878247]
[4]
Jansen TL, Janssen M, van Riel PL. Grand rounds in rheumatology: acute rheumatic fever or post-streptococcal reactive arthritis: a clinical problem revisited. Br J Rheumatol 1998; 37(3): 335-40.
[http://dx.doi.org/10.1093/rheumatology/37.3.335] [PMID: 9566678]
[5]
van der Helm-van Mil AH. Acute rheumatic fever and poststreptococcal reactive arthritis reconsidered. Curr Opin Rheumatol 2010; 22(4): 437-42.
[http://dx.doi.org/10.1097/BOR.0b013e328337ba26] [PMID: 20150812]
[6]
Mackie SL, Keat A. Poststreptococcal reactive arthritis: what is it and how do we know? Rheumatology (Oxford) 2004; 43(8): 949-54.
[http://dx.doi.org/10.1093/rheumatology/keh225] [PMID: 15150434]
[7]
Ahmed S, Ayoub EM, Scornik JC, Wang CY, She JX. Poststreptococcal reactive arthritis: clinical characteristics and association with HLA-DR alleles. Arthritis Rheum 1998; 41(6): 1096-102.
[http://dx.doi.org/10.1002/1529-0131(199806)41:6<1096:AID-ART17>3.0.CO;2-Y] [PMID: 9627020]
[8]
Simonini G, Porfirio B, Cimaz R, Calabri GB, Giani T, Falcini F. Lack of association between the HLA-DRB1 locus and post-streptococcal reactive arthritis and acute rheumatic fever in Italian children. Semin Arthritis Rheum 2004; 34(2): 553-8.
[http://dx.doi.org/10.1016/j.semarthrit.2004.04.001] [PMID: 15505772]
[9]
Fast DJ, Schlievert PM, Nelson RD. Toxic shock syndrome-associated staphylococcal and streptococcal pyrogenic toxins are potent inducers of tumor necrosis factor production. Infect Immun 1989; 57(1): 291-4.
[PMID: 2642470]
[10]
Deighton C. Beta haemolytic streptococci and reactive arthritis in adults. Ann Rheum Dis 1993; 52(6): 475-82.
[http://dx.doi.org/10.1136/ard.52.6.475] [PMID: 8323403]
[11]
Ayoub EM, Ahmed S. Update on complications of group A streptococcal infections. Curr Probl Pediatr 1997; 27(3): 90-101.
[http://dx.doi.org/10.1016/S0045-9380(97)80010-2] [PMID: 9099534]
[12]
Iglesias-Gamarra A, Mendez EA, Cuellar ML, et al. Poststreptococcal reactive arthritis in adults: long-term follow-up. Am J Med Sci 2001; 321(3): 173-7.
[http://dx.doi.org/10.1097/00000441-200103000-00003] [PMID: 11269792]
[13]
Madhuri V, Mathai E, Brahmadathan KN, Korula RJ, John TJ. An outbreak of post-streptococcal reactive arthritis. Indian J Med Res 1997; 105: 249-53.
[PMID: 9277035]
[14]
Abderrahim K, Chebil A, Falfoul Y, Bouladi M, El Matri L. Granulomatous uveitis and reactive arthritis as manifestations of post-streptococcal syndrome. Int Ophthalmol 2015; 35(5): 641-3.
[http://dx.doi.org/10.1007/s10792-012-9626-1] [PMID: 22986580]
[15]
Jansen TL, Janssen M, de Jong AJ, Jeurissen ME. Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever. J Intern Med 1999; 245(3): 261-7.
[http://dx.doi.org/10.1046/j.1365-2796.1999.0438e.x] [PMID: 10205588]
[16]
Livneh A, Sharma K, Sewell KL, Keiser HD. Multisystem disease in post-streptococcal arthritis. Ann Rheum Dis 1991; 50(5): 328-9.
[http://dx.doi.org/10.1136/ard.50.5.328] [PMID: 2042990]
[17]
Mazur E, Czerwińska E, Grochowalska A, Kozioł-Montewka M. Concurrent peritonsillar abscess and poststreptococcal reactive arthritis complicating acute streptococcal tonsillitis in a young healthy adult: a case report. BMC Infect Dis 2015; 15: 50.
[http://dx.doi.org/10.1186/s12879-015-0780-8] [PMID: 25885601]
[18]
Jansen TL, Janssen M, de Jong AJ. Reactive arthritis associated with group C and group G beta-hemolytic streptococci. J Rheumatol 1998; 25(6): 1126-30.
[PMID: 9632075]
[19]
Tamura N, Kobayashi S, Hashimoto H. Anticardiolipin antibodies in patients with post-streptococcal reactive arthritis. Ann Rheum Dis 2002; 61(4): 374.
[http://dx.doi.org/10.1136/ard.61.4.374] [PMID: 11874848]
[20]
Li EK. Rheumatic disorders associated with streptococcal infections. Best Pract Res Clin Rheumatol 2000; 14(3): 559-78.
[http://dx.doi.org/10.1053/berh.2000.0093] [PMID: 10985986]
[21]
Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2009; 119(11): 1541-51.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.191959] [PMID: 19246689]
[22]
Koçak G, Imamoğlu A, Tutar HE, Atalay S, Türkay S. Poststreptococcal reactive arthritis: clinical course and outcome in 15 patients. Turk J Pediatr 2000; 42(2): 101-4.
[PMID: 10936973]
[23]
Perl L, Kvint I, Matitiau A, Levi A, Barash J, Uziel Y. Late cardiac assessment in children diagnosed with post-streptococcal reactive arthritis: a long term study. Clin Exp Rheumatol 2015; 33(4): 578-82.
[PMID: 26203934]
[24]
Sánchez-Cano D, Callejas-Rubio JL, Ortego-Centeno N. Use of adalimumab in poststreptococcal reactive arthritis. J Clin Rheumatol 2007; 13(3): 176.
[http://dx.doi.org/10.1097/RHU.0b013e3180690c1f] [PMID: 17551391]
[25]
Ayoub EM, Majeed HA. Poststreptococcal reactive arthritis. Curr Opin Rheumatol 2000; 12(4): 306-10.
[http://dx.doi.org/10.1097/00002281-200007000-00013] [PMID: 10910184]
[26]
Adiguzel E, Dogan Duran U, Demir Y, Sari S, Safaz I. A rare adult case of sacroiliitis due to poststreptococcal reactive arthritis. Archives of Rheumatology 2015; 30(2): 161-3.
[http://dx.doi.org/10.5606/ArchRheumatol.2015.5539]
[27]
Eroğlu AG. Update on diagnosis of acute rheumatic fever: 2015 Jones criteria. Turk Pediatri Ars 2016; 51(1): 1-7.
[http://dx.doi.org/10.5152/TurkPediatriArs.2016.2397] [PMID: 27103858]
[28]
Gewitz MH, Baltimore RS, Tani LY, Sable CA, Shulman ST, Carapetis J, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015; 131(20): 1806-18.
[http://dx.doi.org/10.1161/CIR.0000000000000205]
[29]
Uziel Y, Perl L, Barash J, Hashkes PJ. Post-streptococcal reactive arthritis in children: a distinct entity from acute rheumatic fever. Pediatr Rheumatol Online J 2011; 9(1): 32.
[http://dx.doi.org/10.1186/1546-0096-9-32] [PMID: 22013970]
[30]
De Cunto CL, Giannini EH, Fink CW, Brewer EJ, Person DA. Prognosis of children with poststreptococcal reactive arthritis. Pediatr Infect Dis J 1988; 7(10): 683-6.
[http://dx.doi.org/10.1097/00006454-198810000-00002] [PMID: 3054776]

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