Märker-Hermann Elisabeth
Klinik Innere Medizin IV (Rheumatologie, Klinische Immunologie und Nephrologie), Helios Dr. Horst Schmidt Kliniken Wiesbaden.
Dtsch Med Wochenschr. 2020 Dec;145(24):1786-1790. doi: 10.1055/a-1036-9359. Epub 2020 Nov 30.
Reactive arthritis (ReA) is an aseptic, immune mediated arthritis with typical manifestations following urogenital, gastrointestinal or respiratory tract infections. The interval between the antecedent infection and arthritis is ranging from several days to 4-6 weeks. ReA is classified as member of the group of spondyloarthritides. The triggering microorganisms are not culturable by routine methods from the affected joints. In the pathogenesis of ReA, bacterial and immunological as well as genetic factors (HLA-B27) play an important role. Post-streptococcal arthritis, Lyme arthritis (Borreliosis) and viral arthritis are not classified as ReA within the spondyloarthritis group. In the treatment of ReA, antibiotics are not used. Acute ReA is treated by nonsteroidal anti-inflammatory drugs, and refractory (chronic) arthritis by steroids, sulfasalazine and TNF inhibitors. Notably, only a few original papers on ReA have been published within the last years.
反应性关节炎(ReA)是一种无菌性、免疫介导的关节炎,在泌尿生殖系统、胃肠道或呼吸道感染后出现典型表现。前驱感染与关节炎之间的间隔时间从几天到4 - 6周不等。ReA被归类为脊柱关节炎组的成员。引发感染的微生物无法通过常规方法从受累关节中培养出来。在ReA的发病机制中,细菌、免疫学以及遗传因素(HLA - B27)起着重要作用。链球菌感染后关节炎、莱姆关节炎(疏螺旋体病)和病毒性关节炎在脊柱关节炎组中不被归类为ReA。在ReA的治疗中,不使用抗生素。急性ReA通过非甾体抗炎药治疗,难治性(慢性)关节炎则通过类固醇、柳氮磺胺吡啶和肿瘤坏死因子抑制剂治疗。值得注意的是,在过去几年里,关于ReA的原创论文只有少数发表。