Abstract
There is currently no agreement on how to classify and diagnose reactive arthritis (ReA) and what kind of clinical and laboratory findings are specific for the diagnosis. This study retrospectively analyzed the initial clinical manifestations and laboratory findings in children diagnosed with ReA and juvenile idiopathic arthritis (JIA). A comparison was also made between these two groups to see if there were differences. A retrospective chart review was performed and 44 patients diagnosed with ReA and 80 patients with JIA were enrolled in this study. Their initial clinical manifestations and laboratory findings were also analyzed and compared. The initial clinical manifestations in ReA were analyzed including the demographic data, the preceding infection history, the duration of the infectious episode to the onset of arthritis, the duration of arthritic symptoms, and the involved joint pattern. Comparison of the initial laboratory findings between patients with ReA and JIA showed significant differences between erythrocyte sedimentation rates (ESR) in the first hour, platelet counts (p<0.05), and ESR in the second hour (p=0.052). Further, comparing ReA with the subtypes of JIA, significant differences were noted between ReA and the systemic type in terms of hemoglobin level, platelet counts, C-reactive protein, and first and second hour ESR (p<0.05). However, if compared with the polyarticular or pauciarticular type, only the platelet counts showed any significant statistical difference (p<0.05). This study summarizes clinical experiences in ReA. The differences in laboratory findings of ReA and JIA may provide a clue in making a differential diagnosis.
Similar content being viewed by others
References
Reiter H (1916) Über eine bisher unerkannate Spirochäteninfektion. Dtsch Med Wochenschr 50:1535–1536
Ahvonen P, Sievers K, Aho K (1969) Arthritis associated with Yersinia enterocolitica infection. Acta Rheum Scand 15:232–253
Inman RD (1999) Classification criteria for reactive arthritis. J Rheumatol 26:1219–1221
Kuipers JG, Köhler L, Zeidler H (1999) Reactive or infectious arthritis. Ann Rheum Dis 58:661–664
Sieper J, Braun J (1995) Pathogenesis of spondylarthropathies: persistent bacterial antigen, autoimmunity or both?. Arthritis Rheum 38:1547–1554
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, MaldonadoCocco J, Orozco-Alcala J, Prieur AM, Suarez-Almazor ME, Woo P (2004) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 31:390–392
Ayoub EM, Majeed HA (2002) Poststreptococcal reactive arthritis. Curr Opin Rheumatol 12:306–310
Pacheco-Tena C, Burgos-Vargas R, Vázuqez Mellado J, Cazarín J, Pérez-daz J (1999) A proposal for the classification of patients for clinical and experimental studies on reactive arthritis. J Rheumatol 26:1338–1346
Braun J, Kingsley G, Heijde D, Sieper J (2000) On the difficulties of establishing a consensus on the definition of and diagnostic investigations for reactive arthritis. Results and discussion of a questionnaire prepared for the 4th international workshop on reactive arthritis, Berlin, Germany, July 3–6, 1999. J Rheumatol 27:2185–2192
Toivanen P, Toivanen A (1999) Two forms of reactive arthritis? Ann Rheum Dis 58:737–741
Sibilia J, Limbach F-X (2002) Reactive arthritis or chronic infectious arthritis? Ann Rheum Dis 61:580–587
Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A et al (1991) The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1227
Kvien TK, Glennås A, Melby K, Granfors K, Andrup O, Karstensen B et al (1994) Reactive arthritis: incidence, triggering agents and clinical presentation. J Rheumatol 21:115–122
Hülsemann JL, Zeidler H (1995) Undifferentiated arthritis in an early synovitis out-patient clinic. Clin Exp Rheumatol 13:37–43
Sieper J, Braun J (1999) Problems and advances in the diagnosis of reactive arthritis. J Rheumatol 26:222–224
Lauhio A, Leirisalo-Repo M, Lähdevirta J, Saikku P, Repo H (1991) Double-blind, placebo-controlled study of three-month treatment with lymecycline in reactive arthritis, with special reference to Chlamydia arthritis. Arthritis Rheum 34:6–14
Sieper J, Fendler C, Laitko S, Sörensen H, Gripenberg-Lerche C, Hiepe F et al (1999) No benefit of long-term ciprofloxacin treatment of patients with reactive arthritis and undifferentiated oligoarthritis: a three-month, multicenter, double-blind, randomized, placebo-controlled study. Arthritis Rheum 42:1386–1396
Sieper J, Rudwaleit M, Braun J, Heijde D (2002) Diagnosing reactive arthritis—role of clinical setting in the value of serologic and microbiologic assays. Arthritis Rheum 46:319–327
Toivanen A, Lahesmaa-Rantala R, Vuento R et al (1987) Association of persisting IgA response with Yersinia trigger reactive arthritis: a study on 104 patients. Ann Rheum Dis 45:898–901
Isomaki O, Vuento R, Granfors K (1989) Serological diagnosis of Salmonella infections by enzyme immunoassay. Lancet 24:1411–1414
Bas S, Griffais R, Kvien TK (1995) Amplification of plasmid and chromosome Chlamydia DNA in synovial fluid of patients with reactive arthritis and undifferentiated seronegative oligoarthropathies. Arthritis Rheum 38:1005–1013
Kulas DT, Schanberg L (2001) Juvenile idiopathic arthritis. Curr Opin Rheumatol 13:392–398
Klinger MH, Jelkmann W (2002) Role of blood platelets in infection and inflammation. Interferon Cytokine Res 22:913–922
Collins CE, Rampton DS (1997) Review article: platelets in inflammatory bowel disease—pathogenetic role and therapeutic implications. Aliment Pharmcol Ther 11:237–247
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liang, TC., Hsu, CT., Yang, YH. et al. Analysis of childhood reactive arthritis and comparison with juvenile idiopathic arthritis. Clin Rheumatol 24, 388–393 (2005). https://doi.org/10.1007/s10067-004-1042-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-004-1042-0