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Yersinia arthritis in children
Insights
Yersinia infections can cause reactive arthritis in children, sometimes leading to persistent joint issues. Early diagnosis and treatment, like chemical synovectomy, can be effective for severe cases.
Area of Science:
- Pediatric Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Yersinia enterocolitica and Yersinia pseudotuberculosis are known pathogens.
- Reactive arthritis can be a complication of bacterial infections.
Purpose of the Study:
- To investigate the incidence and characteristics of Yersinia-induced reactive arthritis in children.
- To evaluate treatment outcomes for persistent synovitis.
Main Methods:
- Retrospective analysis of 37 children hospitalized with Yersinia infections over 10 years.
- Diagnosis confirmed by elevated antibody titers.
- Clinical follow-up and HLA-B27 typing for arthritis patients.
Main Results:
- 13 children developed reactive arthritis, with an average duration of 6.5 months.
- Two patients had persistent arthritis; three underwent successful chemical synovectomy.
- HLA-B27 was present in 11 of 13 arthritis cases, including chronic and treated patients.
Conclusions:
- Reactive arthritis is a significant complication of Yersinia infections in children.
- Chemical synovectomy can be effective for persistent knee synovitis.
- HLA-B27 is associated with Yersinia-induced reactive arthritis.
Abstract:
Over a 10-year period 37 children were hospitalized with infections of Yersinia enterocolitica III, IX or Yersinia pseudotuberculosis IA. The diagnosis was based on elevated antibody titres against these micro-organisms. Thirteen of the children had reactive arthritis caused by Yersinia. The duration of arthritis in the primary phase varied between 3 and 22 months, the average being 6.5 months. Two patients developed persistent arthritis. chemical synovectomy with osmic acid was performed in 3 children because of persistent synovitis in the knee joint. All 3 became asymptomatic after this therapy. The follow-up study of the patients with arthritis was performed after an average period of 4 years 7 months. The histocompatibility antigen HLA-B27 was found in 11 of the 13 children. This group included both patients with chronic arthritis and the 3 synovectomized children. Reactive arthritis in this material was a common, serious complication in an otherwise benign infection.