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Rheumatology Advance Access published online on May 18, 2004
Rheumatology, doi:10.1093/rheumatology/keh225
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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Received January 2, 2004
Accepted April 8, 2004

Original Papers

Poststreptococcal reactive arthritis: what is it and how do we know?

S. L. Mackie 1* A. Keat 1

1 Department of Rheumatology, Northwick Park Hospital, Harrow, Middlesex, UK

* To whom correspondence should be addressed. E-mail: sarah.mackie{at}doctors.org.uk.


  Abstract

Objective. To find out whether poststreptococcal reactive arthritis (PSRA) is a discrete, homogeneous clinical syndrome.

Method. Literature review from case reports and case series.

Results. One hundred and eighty-eight cases were identified. The age distribution was bimodal, with one peak in childhood and one peak in adulthood. Eighty-three per cent of streptococcal isolates were group A. The clinical presentation was heterogeneous but appeared different both from that of acute rheumatic fever (ARF) and from that of HLA B27-associated reactive arthritis. Carditis was rare.

Conclusions. The term PSRA encompasses significant heterogeneity. The link between the arthritis and the streptococcal infection is unproven.

KEY WORDS: Poststreptococcal reactive arthritis, Streptococcal infection, Reactive arthritis.


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