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Post-Streptococcal Reactive Arthritis.

Yasser Bawazir1, Tanveer Towheed2, Tassos Anastassiades2

  • 1Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Current Rheumatology Reviews
|August 9, 2019
PubMed
Summary

Post-Streptococcal Reactive Arthritis (PSRA) presents as joint inflammation after a streptococcal infection, distinct from Acute Rheumatic Fever. Treatment involves NSAIDs or corticosteroids, with most cases resolving spontaneously.

Keywords:
Post-streptococcal reactive arthritisacute rheumatic fevercorticosteroidsdiagnostic criteriareactive arthritisstreptococcal organism.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Immunology

Background:

  • Post-Streptococcal Reactive Arthritis (PSRA) is inflammatory arthritis following a Group A Streptococcus infection, not meeting Acute Rheumatic Fever (ARF) criteria.
  • Distinguishing PSRA from ARF and other forms of reactive arthritis (ReA) is crucial for appropriate management.

Purpose of the Study:

  • To review and summarize current knowledge on PSRA.
  • To delineate the definition, epidemiology, clinical presentation, and treatment of PSRA.
  • To highlight key differences between PSRA, ReA, and ARF.

Main Methods:

  • A narrative review was conducted.
  • Systematic literature search across MEDLINE, EMBASE, Cochrane Library, and Google Scholar (1982-2016).
  • Keywords used: "poststreptococcal reactive arthritis".

Main Results:

  • PSRA affects bimodal age groups (8-14 and 21-37 years) with a near 1:1 male to female ratio.
  • Clinical features include acute, asymmetrical, non-migratory polyarthritis, potentially with extra-articular manifestations; HLA-B27 is not a distinguishing factor.
  • Onset is typically within 10 days post-infection, with arthritis potentially prolonged or recurrent, unlike ARF.

Conclusions:

  • Key clinical features aid in differentiating PSRA from ARF and ReA.
  • NSAIDs and corticosteroids are first-line treatments for PSRA.
  • While many cases resolve spontaneously, some exhibit prolonged or recurrent disease; no randomized controlled trials exist for PSRA.