Reactive arthritis

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6930.671 (Published 12 March 1994) Cite this as: BMJ 1994;308:671
  1. B Svenungsson

    Reactive arthritis is an aseptic arthritis that develops after an infection elsewhere in the body. The triad of arthritis, urethritis, and conjunctivitis -Reiter's syndrome - is one distinct variety of reactive arthritis.

    Many micro-organisms may induce reactive arthritis, and new agents are continuously being added to the list, suggesting a pathogenic mechanism that is not antigen specific. The condition is associated most commonly with urogenital or enteric infections with Chlamydia trachomatis, Yersinia enterocolitica, salmonella, shigella, and campylobacter.1, 2 Less common or more recently identified agents include Clostridium difficile, Vibrio parahaemolyticus, Borrelia burgdorferi, Chl pneumoniae, and ureaplasma. A type of reactive arthritis not associated with HLA-B27 may occur after infections with ß haemolytic streptococci and neisseria. In about one quarter of all cases the triggering organism remains unknown.1

    Between 60% and 90% of patients with postvenereal or postenteric reactive arthritis are positive for HLA-B27.1, 2 The arthritis usually develops within four weeks of the primary infection; it is typically oligoarticular and asymmetric. Painful joints …

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