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Reactive Arthritis.

Steven K Schmitt1

  • 1Section of Bone and Joint Infections, Department of Infectious Disease, Medicine Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk G-21, Cleveland, OH 44195, USA.

Infectious Disease Clinics of North America
|March 16, 2017
PubMed
Summary
This summary is machine-generated.

Reactive arthritis, a type of spondyloarthropathy, is triggered by infection and can cause inflammatory arthritis. Treatment effectiveness varies, with antibiotics useful for Chlamydia infections but less clear for enteric pathogens.

Keywords:
CampylobacterChlamydiaInflammatory arthritisReactive arthritisSalmonellaShigellaSpondyloarthropathyYersinia

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Area of Science:

  • Rheumatology
  • Immunology
  • Infectious Diseases

Background:

  • Reactive arthritis is a spondyloarthropathy characterized by an infectious trigger followed by inflammatory arthritis.
  • The pathogenesis involves complex interactions between host susceptibility and microbial factors.
  • Understanding these mechanisms is crucial for diagnosis and treatment.

Purpose of the Study:

  • To review the current understanding of reactive arthritis, including its triggers, diagnostic criteria, and therapeutic approaches.
  • To discuss the role of antibiotics and emerging therapies like tumor necrosis factor alpha inhibitors.
  • To highlight the variable clinical course and potential for extraarticular manifestations.

Main Methods:

  • Literature review of reactive arthritis, spondyloarthropathies, and related infectious triggers.
  • Analysis of diagnostic approaches combining clinical presentation and microbiological confirmation.
  • Evaluation of current and evolving therapeutic strategies, including antibiotic and immunomodulatory treatments.

Main Results:

  • Diagnosis requires a compatible clinical syndrome and pathogen confirmation.
  • Antibiotic therapy is beneficial for Chlamydia-induced reactive arthritis.
  • The efficacy of antibiotics for enteric pathogen-triggered arthritis is uncertain, and tumor necrosis factor alpha inhibitor therapy is under investigation.

Conclusions:

  • Reactive arthritis is an infection-triggered inflammatory condition with diverse clinical outcomes.
  • Treatment strategies are evolving, with specific considerations for different causative pathogens.
  • While many cases resolve, some patients experience chronic or extraarticular disease, necessitating ongoing research into effective management.