Department of Rheumatology and Immunology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Medicine (Baltimore). 2022 Sep 2;101(35):e30383. doi: 10.1097/MD.0000000000030383.
Reactive arthritis (ReA) is defined as inflammatory arthritis secondary to an extra-articular infection with a key genetic background, HLA-B27. However, to date, the diagnosis and classification remain incomplete. The study focused on the similarities and differences in clinical manifestation, imaging features, and laboratory inspection between HLA-B27 negative patients and HLA-B27 positive patients in order to provide a reference for future development of diagnostic and classification criteria. Twenty-five ReA (19 HLA-B27 negative patients and 6 HLA-B27 positive patients) were included in this retrospective study. Clinical data, including demographics, clinical symptoms, imaging features, and laboratory inspection, were collected. The chi-square test and Mann-Whitney U test were used in the analysis. HLA-B27 negative group showed more involvement of upper extremities and small joints, while HLA-B27 positive group performed more axial symptoms. No significant difference was found in imaging features (ultrasound and magnetic resonance imaging) or laboratory inspection (microbes culture and infection-related indicators) between the 2 groups. ReA patients with different genetic backgrounds show various manifestations, although they encounter similar infections.
反应性关节炎(ReA)定义为伴主要遗传背景 HLA-B27 的关节外感染后继发的炎症性关节炎。然而,迄今为止,其诊断和分类仍不完整。本研究侧重于 HLA-B27 阴性患者和 HLA-B27 阳性患者在临床表现、影像学特征和实验室检查方面的异同,以期为未来的诊断和分类标准的发展提供参考。本回顾性研究纳入了 25 例反应性关节炎(19 例 HLA-B27 阴性患者和 6 例 HLA-B27 阳性患者)。收集了临床数据,包括人口统计学、临床症状、影像学特征和实验室检查。采用卡方检验和曼-惠特尼 U 检验进行分析。HLA-B27 阴性组上肢和小关节受累较多,而 HLA-B27 阳性组轴向症状更多。两组间影像学特征(超声和磁共振成像)或实验室检查(微生物培养和感染相关指标)无显著差异。不同遗传背景的 ReA 患者表现各异,尽管他们遇到了相似的感染。