Reactive arthritis: advances in diagnosis and treatment

Abstract

Reactive arthritis (ReA) is one of the seronegative spondyloarthropathies. ReA is an autoimmune arthritis, frequently preceded by a bacterial infection of the gastrointestinal or genitourinary tract. In 65-85% of patients suffering from ReA, HLA-B27 antigen is present. ReA is a disease with diverse clinical manifestations of the peripheral joints, spine, skin, eyes, digestive and other systems. A variety of symptoms means that patients, especially at the initial stage of the disease, are treated by specialists of different fields of medicine. The clinical picture of ReA is similar irrespective of the preceding infection type, but the therapy depends on the type of bacteria triggering the infection. Chlamydia infection may be persistent and treatment of Chlamydia-induced ReA is based on antibiotics. In other cases, the use of antibiotics is controversial. The course of ReA can be acute and often self-limiting. In some patients, a chronic arthritis develops. Early diagnosis of ReA and its effective treatment may prevent the development of chronic disease and lead to curing the disease completely.