Reactive Arthritis: Update
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BACTERIOLOGY (N BOREL, SECTION EDITOR)
Reactive Arthritis: Update Ibtissam Bentaleb 1 & Kawther Ben Abdelghani 2 & Samira Rostom 1 & Bouchra Amine 1 & Ahmed Laatar 2 & Rachid Bahiri 1 Accepted: 15 September 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose of Review The aim of this paper is to provide an overview about reactive arthritis, with an update regarding pathophysiology and therapeutic approach of the disease, outlining the clinical features and diagnostic approach, based on recent literature review. Recent Findings Reactive arthritis is considered to be part of the spectrum of the spondyloarthritis. Its epidemiology is changing worldwide due to several reasons, among them are as follows: different diagnosis approach and clinical presentations, different grades of infection, microbiome changes, etc. The understanding of pathophysiological models is challenging, but recent studies contribute to elucidate the major factors involved in the development of the disease. The management of ReA depends on the triggering agent and the phase of disease, whether it is acute or chronic. Summary The association between the microbiome changes and spondyloarthropathies (ReA) is becoming increasingly evident. The results regarding the biologic treatment on refectory ReA are promising. Keywords Reactive arthritis . Spondyloarthritis . HLA-B27 . Chlamydia-induced reactive arthritis
Introduction Reactive arthritis (ReA) refers to a group of articular, entheseal, mucocutaneous, and ocular manifestations that occur after a genito-urologic, enteric, or respiratory infection. This article is part of the Topical Collection on Bacteriology * Ibtissam Bentaleb [email protected] Kawther Ben Abdelghani [email protected] Samira Rostom [email protected]
Generally, it is presented as an oligoarthritis usually following infection in the genitourinary (GU) or/and gastrointestinal (GI) tract [1, 2, 3••]. Recent studies related to ReA pathophysiology have highlighted the contribution of the microbiota in the pathogenesis of this type of arthritis [1, 3••, 4•]. In the USA, the frequency of reactive arthritis goes from 3.5 to 5 patients per 100,000 [2]. Due to the diversity in its clinical manifestations, the ReA diagnosis appears to be very challenging and may be missed in clinical practice [2]. There is a risk that ReA can lead to chronic destructive arthritis in the absence of specific management. In fact, an early diagnosis allows an early intervention which may avoid patients’ complications [2].
Bouchra Amine [email protected] Ahmed Laatar [email protected] Rachid Bahiri [email protected] 1
Service of Rheumatology A, El Ayachi Hospital, University Mohamed V Rabat, 11150 Salé, Morocco
2
Faculty of Medicine, Mongi Slim Hospital, University of Tunis EL Manar, 2046 Tunis, Tunisia
Is the Epidemiology of ReA Changing? There are different factors that stand behind the major shift in epidemiological data in ReA worldwide, among them are as follows: different diagnosis approach and clinical presentations
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