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Poststreptococcal reactive arthritis in children: a retrospective study
Lakshmi Nandini Moorthy1, Sunanda Gaur, Margaret G Peterson
1Department of Pediatrics, Robert Wood Johnson Medical School-UMDNJ, New Brunswick, New Jersey, USA. lnmoorthy@mac.com
Clinical Pediatrics
|January 9, 2009
Summary
Antibiotic prophylaxis duration for children with poststreptococcal reactive arthritis (PSRA) remains unclear. Long-term cardiac follow-up is recommended, as clinical features and lab values show improvement over time.
Area of Science:
- Pediatrics
- Rheumatology
- Cardiology
Background:
- Poststreptococcal reactive arthritis (PSRA) in children lacks defined treatment durations and prophylaxis guidelines.
- Cardiac involvement is a significant concern in pediatric PSRA.
Purpose of the Study:
- To evaluate clinical features and outcomes in children with PSRA.
- To determine appropriate antibiotic prophylaxis duration and assess cardiac involvement over time.
Main Methods:
- Retrospective chart review of 40 children diagnosed with PSRA.
- Assessment of clinical features and echocardiogram findings at baseline and 6, 12, and 24 months.
- Monitoring of laboratory markers including erythrocyte sedimentation rate and antibody titers.
Main Results:
- 18% of patients had baseline echocardiogram findings; 2 developed findings after 12 months.
- Mean antibiotic prophylaxis duration was 22 months.
- Significant improvement observed in clinical assessments, joint symptoms, and inflammatory markers over 24 months.
Conclusions:
- Children with PSRA demonstrate marked clinical and laboratory improvement over time.
- Long-term cardiac monitoring is advisable for pediatric patients with PSRA.
- Further research is needed to establish definitive antibiotic prophylaxis guidelines.
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