Reactive arthritis (ReA)
Reactive arthritis (ReA)
is a sterile, inflammatory arthritis that is typically preceded by a
gastrointestinal or genitourinary infection occurring 1 to 4 weeks
previously. Similar to other spondyloarthritis, patients with ReA
are more likely to be human leukocyte antigen-B27 (HLA-B27) positive,
which portends a worse prognosis and more joint and extraarticular
manifestations.
Infectious agents “causing” ReA:
Urogenital | Chlamydia trachomatis, Ureaplasma urealyticum |
Enterogenic | Salmonella typhimurium, Salmonella enteritidis, Salmonella Heidelberg, Salmonella choleraesuis |
| Shigella flexneri, Shigella dysenteriae, Shigella sonnei |
| Yersinia enterocolitica, Yersinia pseudotuberculosis |
| Campylobacter jejuni |
Others | Clostridium difficile |
| Chlamydia pneumoniae |
| Vibrio parahaemolyticus |
| Borrelia burgdorferi |
| Neisseria gonorrhoeae |
| Streptococcus (post-Streptococcal ReA) |
| Hepatitis C |
| Giardia lamblia |
| Mycoplasma |
Note: In 40% of ReA patients an infectious agent cannot be identified. Urine PCR for Chlamydia and stool cultures may be helpful in patients with urethritis or diarrhea, respectively. Serologic tests for Chlamydia, Salmonella, and Yersinia can be done depending on the suspected inciting agent.
Web:
American College of Rheumatology