Reactive arthritis overview: Difference between revisions
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==Causes== | ==Causes== | ||
Common causes of reactive arthritis include [[infection]] with [[Chlamydia trachomatis]], [[Neisseria gonorrhoeae]], [[Salmonella enteritidis]], [[Shigella flexneri]], [[Campylobacter jejuni]], [[Mycoplasma pneumoniae]], [[Lymphogranuloma venereum]], [[Mycobacterium tuberculosis]], [[Clostridium difficile]], and [[Streptococci|Streptococci viridans]]. | |||
==Differentiating {{PAGENAME}} from Other Diseases== | ==Differentiating {{PAGENAME}} from Other Diseases== | ||
Revision as of 15:28, 12 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Reactive arthritis (ReA) is an autoimmune condition that develops in response to an infection in another part of your body. Coming into contact with bacteria and developing an infection can trigger reactive arthritis. Reactive arthritis has symptoms similar to arthritis or rheumatism. It is caused by another disease, and is thus "reactive", i.e., dependent on the other condition. The "trigger" infection is typically missing in the chronic case.
Reactive arthritis is the combination of three seemingly unlinked symptoms—an inflammatory arthritis of large joints, inflammation of the eyes (conjunctivitis and uveitis), and urethritis. A useful mnemonic is "the patient can't see, can't pee and can't climb a tree". It is also known as arthritis urethritica, venereal arthritis and polyarteritis enterica. It is a type of seronegative spondyloarthropathy.
Reactive arthritis is an RF-seronegative, HLA-B27-linked spondyloarthropathy (autoimmune damage to the cartilages of joints) often precipitated by genitourinary or gastrointestinal infections.
It most commonly strikes individuals aged 20-40, it is more common in men than in women, and more common in white men than in black men. This is due to white individuals being more likely to have tissue type HLA-B27 than black individuals. People with HIV have an increased risk of developing reactive arthritis as well. Food poisoning is a common cause.
Historical Perspective
In fourth century B.C, Hippocrates was the first to associate the presence of arthritis and infection in the genitourinary tract. In 1818, Sir Benjamin Brodie, an English physician was the first to describe the triad of urethritis, arthritis, and conjunctivitis. In 1916, several reports from France & Germany showed association between diarrhea and post-infection arthritis.
Classification
Reactive arthritis (ReA) can be classified on the basis of previous gastrointestinal (GI) or genitourinary (GU) infection in to venereal or dysenteric ReA.
Pathophysiology
It is thought that reactive arthritis is the result of previous gastrointestinal or genitourinary infections, which results in an autoimmune condition. The most commonly associated organisms include Chlamydia, Yersinia, Salmonella, Shigella, and Campylobacter infection. It is estimated around 75% patients of reactive arthritis are positive for HLA-B27. The exact mechanism by which infecting organism cause reactive arthritis is not fully understood. It is thought that microbial antigens are similar to certain body proteins (self proteins). When an immune response is mounted against the microbial proteins, the antibodies produced against microbial proteins also reacts with the self proteins of the body causing reactive arthritis.
Causes
Common causes of reactive arthritis include infection with Chlamydia trachomatis, Neisseria gonorrhoeae, Salmonella enteritidis, Shigella flexneri, Campylobacter jejuni, Mycoplasma pneumoniae, Lymphogranuloma venereum, Mycobacterium tuberculosis, Clostridium difficile, and Streptococci viridans.