Followup study on patients with reiter's disease and reactive arthritis, with special reference to HLA—B27

Leirisalo, M; Skylv, Grethe; Kousa, M; Voipio‐Pulkki, Liisa‐Maria; Suoranta, H; Nissilä, M; Hvidman, Lone; Nielsen, E. Damm; Svejgaard, A.; Tiilikainen, A; Laitinen, Ossi

doi:10.1002/art.1780250302

Cited by 212 publications

(108 citation statements)

References 41 publications

(30 reference statements)

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“…Previous investigators have suggested that arthritis resolves in less than 1 year in all cases (6,11,13), although Hakansson et a1 described symptoms that extended beyond 10 months (8). Leirisalo et a1 (19) reported the late appearance of ankylosing spondylitis in 2 cases of Salmonella reactive arthritis, but this has not been observed in our patients.…”

Section: Discussioncontrasting

confidence: 58%

Postdysenteric reactive arthritis

Inman

Johnston

Hodge

et al. 1988

Arthritis & Rheumatism

107

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Following an outbreak of foodborne gastroenteritis caused by Salmonella typhimurium, questionnaires were sent to affected individuals and then to the family physicians of any who experienced extra‐enteric complications. Of 260 individuals infected with S typhimurium for whom adequate data were obtained, 19 patients developed joint disease (7.3%). All were men; the mean age ± SD was 39.3 ± 1.6 years. Among the 16 patients for whom this information was available, the interval from the onset of diarrhea to the onset of joint pain was <7 days in 7, 8–21 days in 2, and >21 days in 7. There was a significantly longer duration of diarrhea in those patients with joint disease (mean ± SEM 15.2 ± 2.6 days) than in those without complications (10.0 ± 1.1 days) (P < 0.01). The joint disease was monarticular in 3 patients and polyarticular in 16. The joints most commonly affected were the elbow (47%), wrist (47%), knee (42%), low back (32%), and shoulder (32%). Six of the 19 patients had at least 1 extraarticular feature: ocular (5 patients), mucosal (1 patient), urethral (2 patients), or cutaneous (1 patient). Of these 19 patients, 11 were located and agreed to HLA typing. Four were positive for HLA—B27, 6 were HLA—B7 positive, and 1 had HLA—Bw60. Of the 4 B27 positive patients, 3 were DR1 positive; of the 6 B7 positive patients, 5 were DR2 positive. A followup assessment 12.1 months after the acute infection revealed that of the 15 patients with arthritis (4 patients were lost to followup), 8 no longer had symptoms and 7 had persistent joint symptoms. Mucosal and urethral symptoms had resolved in all, and ocular symptoms had resolved in 90%. These findings highlight the interplay of microbe and major histocompatibility complex, a phenomenon that appears to be a precondition for the development of reactive arthritis.

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Section: Discussioncontrasting

confidence: 58%

Postdysenteric reactive arthritis

Inman

Johnston

Hodge

et al. 1988

Arthritis & Rheumatism

107

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“…If arthritis, conjunctivitis and urethritis are present as a triad, reactive arthritis might be referred to as Reiter's syndrome. c. A number of children, particularly those with HLA-B27, develop a chronic course, and may even develop AS (Leirisalo, Skylv et al 1982;Hussein 1987;Artamonov, Akhmadi et al 1991;Cuttica, Scheines et al 1992;Yli-Kerttula, Tertti et al 1995;Leirisalo-Repo, Helenius et al 1997;Leirisalo-Repo 1998). Children without HLA-B27 who have ReA, particularly when the disease is triggered by Yersinia or Campylobacter, usually have a rather short and benign course.…”

Section: Reactive Arthritis (Rea)mentioning

confidence: 99%

“…HLA-B27 positive disease is associated with more severe and more frequent episodes of active oligoarthritis or polyarthritis, sacroillitis and axial involvement often. It also predicts evolvement to ankylosing spondylitis (AS) (Leirisalo, Skylv et al 1982;Leirisalo-Repo 1998). The long-term follow-up of children with HLA-B27 who have JIA reveals that between 18,5% and 75% develop spondyloarthritis (Burgos-Vargas, Pacheco-Tena et al 2002).…”

Section: Undiffentiated Spondyloarthritis (Era)mentioning

confidence: 99%

Juvenile Spondyloarthritis

Harjaček¹,

Lamot²,

Tambic³

et al. 2011

Challenges in Rheumatology

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“…A prolonged (Ͼ1-year) extension of acute arthritis has been described in about 4% of cases of Yersinia arthritis, in 19% of cases of Salmonella arthritis, in 19% of cases of Shigella arthritis, and in 17% of cases Chlamydia arthritis (91,119,120). Depending on the triggering infection and on the follow-up time, chronic arthritis is observed in 2 to 18% of patients, sacroiliitis is observed in 14 to 49%, and AS is observed in 12 to 26% (91,117,200). In one of the earliest studies of ReA, chronic disability was found in 40 of 100 persons who were available for reexamination 25 years after onset of disease (34).…”

Section: Coursementioning

confidence: 99%

HLA-B27-Associated Reactive Arthritis: Pathogenetic and Clinical Considerations

2004

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Current evidence supports the concept that reactive arthritis (ReA) is an immune-mediated synovitis resulting from slow bacterial infections and showing intra-articular persistence of viable, nonculturable bacteria and/or immunogenetic bacterial antigens synthesized by metabolically active bacteria residing in the joint and/or elsewhere in the body. The mechanisms that lead to the development of ReA are complex and basically involve an interaction between an arthritogenic agent and a predisposed host. The way in which a host accommodates to invasive facultative intracellular bacteria is the key to the development of ReA. The details of the molecular pathways that explain the articular and extra-articular manifestations of the disease are still under investigation. Several studies have been done to gain a better understanding of the pathogenesis of ReA; these constitute the basis for a more rational therapeutic approach to this disease

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Followup study on patients with reiter's disease and reactive arthritis, with special reference to HLA—B27

Cited by 212 publications

References 41 publications

Postdysenteric reactive arthritis

Postdysenteric reactive arthritis

Juvenile Spondyloarthritis

HLA-B27-Associated Reactive Arthritis: Pathogenetic and Clinical Considerations

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