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Rheumatology 2002; 41: 312-318
© 2002 British Society for Rheumatology

Original Papers

Campylobacter-triggered reactive arthritis: a population-based study

T. Hannu, L. Mattila1,2, H. Rautelin3, P. Pelkonen4, P. Lahdenne4, A. Siitonen2 and M. Leirisalo-Repo

Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital,
1 Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital,
2 Laboratory of Enteric Pathogens, National Public Health Institute, Helsinki,
3 Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, and Helsinki University Central Hospital Laboratory Diagnostics and
4 Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland

Objective. To study the incidence and clinical picture of Campylobacter-associated reactive arthritis (ReA) and other reactive musculoskeletal symptoms in the population.

Methods. A questionnaire on enteric and extraintestinal, including specifically musculoskeletal, symptoms was sent to 870 consecutive patients with Campylobacter-positive stool culture and 1440 matched controls. Analysis of self-reported musculoskeletal symptoms with clinical examination was performed.

Results. Forty-five of the patients (7%) had ReA and eight (1%) had reactive tendinitis, enthesopathy or bursitis. No child had ReA. The arthritis was oligo- or polyarticular, and, in most cases, mild. HLA-B27 was positive in 14% of ReA patients. Of the 45 ReA patients, 37 had C. jejuni and 8 had C. coli infection. No controls had ReA.

Conclusion. ReA is common following Campylobacter infection, with an annual incidence of 4.3 per 100000. At the population level, acute ReA is mild, more frequent in adults, and not associated with HLA-B27. Besides C. jejuni, C. coli can trigger ReA.

KEY WORDS: Reactive arthritis, Campylobacter jejuni, Campylobacter coli, Population-based study.

Correspondence to: T. Hannu, Department of Medicine, Division of Rheumatology, Helsinki University Central Hospital, PO Box 263, FIN-00029 HUCH, Finland.


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