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  • Title: [Reactive arthritis].
    Author: Stegert M.
    Journal: Ther Umsch; 2023 Feb; 80(1):34-38. PubMed ID: 36659843.
    Abstract:
    Reactive arthritis Abstract. Reactive Arthritis is a sterile, inflammatory arthritis that is typically preceded by a bacterial gastrointestinal or urogenital infection occurring one to four weeks previously. The typical pattern is an asymmetric oligoarthritis most common affecting the lower extremities. Similar to other spondyloarthropathies, enthesitis, dactylitis, and sacroiliitis can occur as well as extra-articular manifestations, such as conjunctivitis, anterior uveitis, oral ulcers, circinate balanitis, and keratoderma blennorrhagicum. The treatment of "triggering" infection with antibiotics is the first therapeutic goal, especially for Chlamydia trachomatis. For arthritis NSAIDs are the treatment of first choice, followed by intraarticular or oral glucocorticosteroids. DMARDs (Sulfasalzine, TNF-alpha inhibitors) are reserved for refractory cases. Over 50% of the patients have a self-limited course lasting two to six months, 30% have recurrent episodes, and 10-20% have a chronic course requiring immunosuppressive therapy. Zusammenfassung. Die reaktive Arthritis (ReA) ist eine sterile Arthritis, welche ein bis vier Wochen nach bestimmten bakteriellen gastrointestinalen- oder urogenitalen Infektionen auftritt. Die typische Manifestation ist eine asymmetrische Oligoarthritis der grossen Gelenken der unteren Extremitäten. Die reaktive Arthritis gehört zu der Gruppe der Spondylarthropathien und die Patienten weisen häufig extraartikuläre Manifestationen an den Augen (Konjunktivitis, anteriore Uveitis), der Haut (enorale Aphten, Balanitis circinata und Keratoderma blennorrhagicum) sowie Enthesitis und Daktylitis. Mehr als 50% der Patienten erholen sich komplett innert zwei bis sechs Monaten, 30% haben rezidivierende Episoden, und 10–20% entwickeln eine chronische Form mit Bedarf an Immunosuppression.
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