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Rheumatic Fever and post-group a streptococcal arthritis in children

Judith Barash1

  • 1Pediatric Day Care, Kaplan Medical Center, Rehovot. Affiliated to the Hadassah Medical School, the Hebrew University, Rehovot, Israel, barashj@inter.net.il.

Current Infectious Disease Reports
|April 10, 2013
PubMed

Insights

Group A beta-hemolytic streptococcal infections can cause acute rheumatic fever (ARF) or poststreptococcal reactive arthritis (PsRA). While debated, evidence suggests PsRA is a distinct condition, not part of the ARF spectrum.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Immunology

Background:

  • Group A beta-hemolytic streptococcal (GABHS) infections are linked to several diseases.
  • Acute rheumatic fever (ARF) and poststreptococcal reactive arthritis (PsRA) are the most common sequelae.
  • A debate exists on whether ARF and PsRA are distinct or part of the same disease spectrum.

Purpose of the Study:

  • To describe epidemiological and clinical data for ARF and PsRA.
  • To review current treatment and prevention strategies for ARF and PsRA.
  • To present evidence supporting PsRA as a distinct entity separate from ARF.

Main Methods:

  • Review of epidemiological and clinical data for ARF and PsRA.
  • Analysis of existing literature on disease characteristics, immunology, and genetics.
  • Comparison of clinical manifestations and outcomes between ARF and PsRA.

Main Results:

  • GABHS infections are associated with ARF and PsRA, with distinct epidemiological and clinical profiles.
  • While some cases suggest overlap (e.g., carditis after PsRA), significant differences exist.
  • Substantial clinical, immunological, and genetic distinctions differentiate PsRA from ARF.

Conclusions:

  • Poststreptococcal reactive arthritis (PsRA) is considered a distinct entity.
  • PsRA is not merely a variant or part of the acute rheumatic fever (ARF) disease spectrum.
  • Further research into the distinct pathophysiology of PsRA is warranted.

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