Skip to main content

Advertisement

Log in

Clinical presentations of chlamydial and non-chlamydial reactive arthritis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of this study was to investigate the triggering micro-organisms and the clinical as well as laboratory differences between Chlamydial and non-chlamydial reactive arthritis (ReA) in a prospective study on 98 patients with acute/subacute arthritis. An inciting organism was found in 42 patients. Eighteen of these were chlamydial. Fifty-seven percent of all ReA patients were carriers for HLA-B27, which increased to 67% in the chlamydial group. Chlamydial ReA patients had more urethritis (P<0.05) with a longer period between arthritis and inciting infection, significantly lower CRP levels, and involved joint counts (P<0.05). Additionally, sacroiliitis was more frequent besides extra-articular manifestations in chlamydial ReA group. This study shows that chlamydial ReA differs in some points from non-chlamydial ReA, which in turn may affect the evaluation of an arthritic patient. ReA due to chlamydia more frequently encompasses a monoarticular or oligoarticular clinical picture with predominant distal extremity involvement. Non-chlamydial ReA presents higher joint counts and may involve upper extremity joints.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sigal LH (2001) Update on reactive arthritis. Bull Rheum Dis 50:1–4

    PubMed  CAS  Google Scholar 

  2. Wuorela M (1998) Infectious agents as triggers of reactive arthritis. Am J Med Sci 316:264–270

    Article  PubMed  CAS  Google Scholar 

  3. Toivanen A (1998) Rheumatology In: Klippel JH, Diappe PA (eds) Mosby, 2nd edn. London, pp 6.11.1–7

  4. Cush JJ (1997) Koopman and Allied Conditions. A text book of Rheumatolgy. Williams and Wilkins, Pennsylvania, pp S1209–S1227

    Google Scholar 

  5. Flores D, Morquez J, Garza M, Espinoza LR (2003) Reactive arthritis: never developments. Rheum Dis Clin N Am 29:37–59

    Article  Google Scholar 

  6. Calin A (1998) The Spondylarthritides In: Calin A, Taurog JD (eds) Oxford University press, Oxford, pp 41–57

  7. Erlacher L, Wintersberger W, Menschik M, Benke-Studnicka A, Machold K, Stanek G, et al (1995) Reactive Arthritis: Urogenital swab culture ıs the only useful diagnostic method for the detection of the arthritogenic ınfection in extra-articularly asymptomatic patients with undifferentiated oligoarthritis. Br J Rheumatol 34:838–842

    Article  PubMed  CAS  Google Scholar 

  8. Barth WF, Segal K (1999) Reactive arthritis (Reiter’s syndrome). Am Fam Physician 60:499–503

    PubMed  CAS  Google Scholar 

  9. Hopkinson N (2000) Sexually-acquired reactive arthritis. Hosp Med 62:83–85

    Google Scholar 

  10. Frendler C, Laitko S, Sörensen H, Groh A (2001) Frequency of triggering bacteria in patients with reactive arthritis and undifferentiated oligoarthritis and the relative importance of the tests used for diagnosis. Ann Rheum Dis 60:337–343

    Article  Google Scholar 

  11. Hannu T, Puolakkainen M, Leirisalo-Repo M (1999) Chlamydia pneumoniae as a triggering infection in reactive arthritis. Rheumatology 38:411–414

    Article  PubMed  CAS  Google Scholar 

  12. Weyand CM, Goronzy J (1992) Clinically silent infections in patients with oligoarthritis: results of a prospective study. Ann Rheum Dis 51:253–258

    Article  PubMed  CAS  Google Scholar 

  13. Zeidler H, Kuipers J, Köhler L (2004) Chlamydia-induced arthritis. Curr Opin Rheumatol 16:380–392

    Article  PubMed  Google Scholar 

  14. Braun J, Laitko S, Treharne J, Eggens U (1994) Chlamydia pneumoniae—a new causative agent of reactive atrhritis and undifferentiated oligoarthritis. Ann Rheum Dis 53:100–105

    PubMed  CAS  Google Scholar 

  15. Fan PT, Yu DTY (1997) Reiter’s syndrome. In: Kelley N, Ruddy S, Harris E, Seledge C (eds) Textbook of rheumatology. WB Saunders, Philadelphia, pp S983–S997

    Google Scholar 

  16. Zeidler HK, Schumacher HR (1998) Chlamydia-induced arthritis. In: Calin A, Taurog J (eds) The spondylarthritides. Oxford University Press, NY, pp 69–96

    Google Scholar 

  17. Fink CW (1988) Reactive arthritis. Pediatr Infect Dis J 7(1):58–65

    Article  PubMed  CAS  Google Scholar 

  18. Otterness IG (1994) The value C-reactive protein measurement in rheumatoid arthritis. Semin arthritis Rheum 24:91–104

    Article  PubMed  CAS  Google Scholar 

  19. Eberl G, Studnicka-Benke A, Hitzelhammer H, Gschnait F, Smolen JS (2003) Development of a disease activity index for the assessment of reactive arthritis (DAREA). Rheumatology (Oxford) 39:148–155

    Article  Google Scholar 

  20. Schumacher HR (2000) Chlamydia-associated reactive arthritis. IMAJ 2:532–535

    PubMed  Google Scholar 

  21. Zeidler H, Wollenhaupt J (1991) Chlamydia-induced arthritis: the clinical spectrum, serology, and prognosis. In: Lipsy PE, Taurog JD (eds) HLA-B27 Spondyloarthropathies. Elsevier, NY, pp 175–187

    Google Scholar 

  22. Arnett FC (1989) The lyme spirocheta: another cause of Reiter’s S? Arthritis Rheum 32:1182–1184

    Article  PubMed  CAS  Google Scholar 

  23. Goobar JP (1977) Joint symptoms in giardiasis (letter). Lancet 1:1010–1011

    Article  PubMed  CAS  Google Scholar 

  24. Doury P, Eulry F, Pattin S (1983) Clinical aspects of reactive arthritis caused by Chlamydia. Rev Rhum Mal Osteoartic 50(11):753–757

    PubMed  CAS  Google Scholar 

  25. Dubost JJ, Constantin A, Soubrier M, Ristori JM, Cantagrel A, Bussiere JL (1997) Does reactive arthritis caused Brucella exist? Apropos of 4 cases. Presse Med 26(5):207–210

    PubMed  CAS  Google Scholar 

  26. Ozgul A, Yazıcıoğlu K, Gunduz S, Kalyon TA, Arpacıoğlu O (1998) Acute brucella sacroiliitis: clinical features. Clin Rheumatol 17(6):521–523

    Article  PubMed  CAS  Google Scholar 

  27. Maki-Ikola O, Gransfors K (1992) Salmonella-triggered reactive arthritis. The Lancet 339:1096–1098

    Article  CAS  Google Scholar 

  28. Locht H, Molbak K, Krogfelt KA (2002) High frequency of reactive joint symptoms after an outbreak of Salmonella enteridis. J Rheumatol 29:767–771

    PubMed  Google Scholar 

  29. Tupchong M, Sımor A, Dewar C (1999) Beaver fever-A rare cause of reactive arthritis. J Rheumatol 26:2701–2702

    PubMed  CAS  Google Scholar 

  30. Shulman St, Ayoub EA (2002) Poststreptococcal reactive arthritis. Curr Opin Rheumatol 14:562–565

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ahmet Özgül.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Özgül, A., Dede, I., Taskaynatan, M.A. et al. Clinical presentations of chlamydial and non-chlamydial reactive arthritis. Rheumatol Int 26, 879–885 (2006). https://doi.org/10.1007/s00296-005-0094-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-005-0094-z

Keywords

Navigation