Reactive Arthritis: Update

Abstract

Purpose of Review The aim of this paper is to provide an overview about reactive arthritis, with an update regarding pathophysiology and therapeutic approach of the disease, outlining the clinical features and diagnostic approach, based on recent literature review. Recent Findings Reactive arthritis is considered to be part of the spectrum of the spondyloarthritis. Its epidemiology is changing worldwide due to several reasons, among them are as follows: different diagnosis approach and clinical presentations, different grades of infection, microbiome changes, etc. The understanding of pathophysiological models is challenging, but recent studies contribute to elucidate the major factors involved in the development of the disease. The management of ReA depends on the triggering agent and the phase of disease, whether it is acute or chronic. Summary The association between the microbiome changes and spondyloarthropathies (ReA) is becoming increasingly evident. The results regarding the biologic treatment on refectory ReA are promising.

Reactive arthritis after COVID-19: a case-based review

“…ReA is diagnosed more frequently in young adults and it has been revealed that cases are concentrated between the ages of 18 and 40 years [ 39 ]. The median age of ReA cases after COVID-19 was seen to be 50 years and was considered to be slightly higher than the literature data.…”

A case report of monoarthritis in a COVID-19 patient and literature review

“…ReA concept is a recent object of revisiting, especially through the observed epidemiological reduction of sex-transmitted disease in high-income countries as well as recognition of miscellaneous pathogens responsible for the disease. [ 12 , 13 ] Among miscellaneous responsible pathogens, some viruses are enlisted and the first COVID-19-related ReA cases start to emerge, [ 10 ] as we aforementioned.…”

A Case Report and Review of the Literature: Reactive Arthritis Caused by Clostridioides difficile ribotype 027

“…He reported having had reactive arthritis after enteric Salmonella infection more than 30 years ago. Although determination of HLA-B27 was not done at that time, an association between this phenotypic marker and reactive arthritis is well known making it likely that the patient’s tendency to develop reactive arthritis after infection with defined intestinal pathogens (e.g., Salmonella enterica and C. difficile ) is at least partially linked to HLA-B27 ( Bentaleb et al, 2020 ). Even if this evidence attaches a role to HLA-B27 in the development of post-infectious reactive arthritis, only 59% of the described patients were positive for this biomarker ( Table 1 ), making its precise involvement in pathogenesis still debatable ( Bentaleb et al, 2020 ).…”