title: Differentiation of post-streptococcal reactive arthritis from acute rheumatic fever.
abstract: OBJECTIVE
  To perform a retrospective study comparing clinical and laboratory aspects of patients with acute rheumatic fever (ARF) and patients with post-streptococcal reactive arthritis (PSRA), to discern whether these are 2 separate entities or varying clinical manifestations of the same disease.
  
  
  METHODS
  We located the records of 68 patients with ARF and 159 patients with PSRA, whose diseases were diagnosed with standardized criteria and treated by 8 pediatric rheumatologists in 7 medical centers, using the Israeli internet-based pediatric rheumatology registry. The medical records of these patients were reviewed for demographic, clinical, and laboratory variables, and the data were compared and analyzed with univariate, multivariate, and discriminatory analysis.
  
  
  RESULTS
  Four variables were found to differ significantly between ARF and PSRA and serve also as predictors: sedimentation rate, C-reactive protein, duration of joint symptoms after starting anti-inflammatory treatment, and relapse of joint symptoms after cessation of treatment. A discriminative equation was derived that enabled us to correctly classify >80% of the patients.
  
  
  CONCLUSIONS
  On the basis of simple clinical and laboratory variables, we were able to differentiate ARF from PSRA and correctly classify >80% of the patients. It appears that ARF and PSRA are distinct entities.
authors.affiliation: Pediatric Day Care and Pediatric Rheumatology Service, Kaplan Medical Center, Rehovot, Hebrew University, Jerusalem, Israel. judith_b@clalit.org.il
authors.forename: Judith
authors.initials: J
authors.lastname: Barash
authors.forename: Eran
authors.initials: E
authors.lastname: Mashiach
authors.forename: Pnina
authors.initials: P
authors.lastname: Navon-Elkan
authors.forename: Yackov
authors.initials: Y
authors.lastname: Berkun
authors.forename: Liora
authors.initials: L
authors.lastname: Harel
authors.forename: Tsivia
authors.initials: T
authors.lastname: Tauber
authors.forename: Shai
authors.initials: S
authors.lastname: Padeh
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Hashkes
authors.forename: Yosef
authors.initials: Y
authors.lastname: Uziel
mesh_terms: D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D016918:Arthritis, Reactive / Q000175:diagnosis*; D002097:C-Reactive Protein / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D007557:Israel; D015999:Multivariate Analysis; D010372:Pediatrics / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000175:diagnosis*; D012219:Rheumatology / Q000379:methods; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis*; D013297:Streptococcus pyogenes / Q000378:metabolism*
chemical_list: D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein