[Reactive arthritis - a disease almost forgotten?]

Area of Science:

• Rheumatology
• Immunology
• Infectious Diseases

Background:

• Reactive arthritis (ReA) is an aseptic, immune-mediated arthritis.
• It typically follows urogenital, gastrointestinal, or respiratory tract infections.
• ReA is classified within the spondyloarthritis group.

Purpose of the Study:

• To define Reactive Arthritis (ReA).
• To outline its classification, pathogenesis, and treatment.
• To highlight the limited recent publications.

Main Methods:

• Review of existing literature on Reactive Arthritis.
• Classification based on clinical manifestations and preceding infections.
• Discussion of pathogenetic factors including genetics (HLA-B27).

Main Results:

• Triggering microorganisms are not typically found in affected joints.
• Bacterial, immunological, and genetic factors (HLA-B27) are key in ReA pathogenesis.
• Post-streptococcal, Lyme, and viral arthritis are excluded from ReA classification.

Conclusions:

• Antibiotics are not indicated for ReA treatment.
• Acute ReA is managed with NSAIDs.
• Refractory ReA requires steroids, sulfasalazine, or TNF inhibitors.