Poststreptococcal reactive arthritis.
Poststreptococcal reactive arthritis (PSRA) refers to a poststreptococcal arthritic condition that does not fulfill the Jones Criteria for diagnosis of acute rheumatic fever. Clinical features include additive rather than migratory arthritis that responds relatively poorly to salicylates and nonsteroidals; persistence for mean of 2 months; elevated acute phase reactants; and laboratory (usually serologic) evidence of recent group A streptococcal infection. PSRA is not associated with HLA-B27 but rather with HLA-DRB1*01. Because up to 6% of PSRA patients develop mitral valve disease, it is recommended that antistreptococcal prophylaxis be administered for 1 year and then discontinued if there is no evidence of cardiac involvement.
Shulman
Stanford T
ST
Department of Pediatrics, Northwestern University, Feinberg School of Medicine, The Children's Memorial Hospital, Chicago, Illinois 60614-3394, USA. sshulman@northwestern.edu
Ayoub
Elia M
EM
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001171:Arthritis, Juvenile / Q000209:etiology / Q000473:pathology; D016918:Arthritis, Reactive / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006801:Humans; D012213:Rheumatic Fever / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains