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Reactive arthritis after pharyngeal infection: report of two siblings

J Asakawa1, Y Torikoe, I Kondo

  • 1Department of Medicine, Yanagibashi Hospital , 2-20-4 Yanagibashi, Taito-ku, Tokyo 111-0052 , Japan.

Modern Rheumatology
|January 4, 2014
PubMed

Insights

Two siblings experienced severe reactive arthritis (ReA) following throat infections. Prompt treatment with NSAIDs and antibiotics led to full recovery, suggesting post-streptococcal reactive arthritis (PSRA) in this HLA-B27-negative family.

Area of Science:

  • Rheumatology
  • Immunogenetics
  • Infectious Diseases

Background:

  • Reactive arthritis (ReA) can be triggered by various infections.
  • Human Leukocyte Antigen (HLA) associations are known for ReA, particularly HLA-B27.
  • Understanding genetic predispositions is crucial for diagnosing and managing ReA.

Purpose of the Study:

  • To report two sibling cases of reactive arthritis following pharyngeal infections.
  • To investigate the potential link between specific HLA types and ReA in a familial context.
  • To differentiate ReA from other conditions like rheumatic fever.

Main Methods:

  • Clinical case reporting of two siblings with arthritis.
  • Diagnostic evaluation including antistreptolysin O (ASO) and antistreptokinase (ASK) titers, and pharyngeal cultures.
  • Human Leukocyte Antigen (HLA) typing for both patients.

Main Results:

  • Both siblings presented with severe reactive arthritis post-pharyngeal infection, requiring hospitalization.
  • Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics resulted in full recovery within 1-2 weeks.
  • HLA typing revealed HLA-B40 in the brother and HLA-B39 in the sister, both associated with HLA-B27-negative ReA.

Conclusions:

  • The cases suggest a familial predisposition to post-streptococcal reactive arthritis (PSRA) in HLA-B27-negative individuals.
  • The findings highlight the importance of considering PSRA in HLA-B27-negative patients with ReA following infections.
  • Early diagnosis and appropriate treatment are key for favorable outcomes in ReA.

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