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[反应性关节炎综合征。风湿病学的局限]

[The reactive arthritis syndrome. Rheumatological limits].

作者信息

Delcambre B, Siame J L, Duquesnoy B

出版信息

Rev Rhum Mal Osteoartic. 1983 Nov;50(11):745-52.

PMID:6607499
Abstract

The term reactive arthritis (RA) refers to an inflammatory joint disease in the absence of bacteria in the joint, but which is caused by a distant extra-articular infection. They occur as a result of a variety of infections, which are essentially genital or gastro-intestinal in subjects with a particular genetic predisposition characterized by the presence of the HLA-B27 antigen or one of the CREG group of antigens (B7 - B27 - BW22 - BW42). The most complete clinical expression of reactive arthritis is the Fiessinger-Leroy-Reiter syndrome. Apart from the reactive arthritis with a generally accepted aetiology such as those following infections of the genital tract (Chlamydia trachomatis, Ureaplasma urealyticum or of the gastrointestinal tract: Yersinia enterocolitica and pseudotuberculosis, Shigella flexneri, Salmonella minor, Campylobacter jejuni), the authors discuss the possibility of including, in a broader definition of RA, post-streptococcal arthritis and cases of arthritis following gonococcal, meningococcal and Brucella infections. RA does not always have a favourable clinical course. It is not exceptional to see a picture of recurrences with progression towards chronic inflammatory rheumatism.

摘要

反应性关节炎(ReA)这一术语指的是关节内没有细菌,但由远处关节外感染引起的炎性关节疾病。它是由多种感染引发的,在具有特定遗传易感性的个体中,这些感染主要是生殖器或胃肠道感染,其特征为存在HLA - B27抗原或CREG抗原组(B7 - B27 - BW22 - BW42)中的一种。反应性关节炎最完整的临床表型是菲辛格 - 勒鲁瓦 - 赖特综合征。除了具有普遍认可病因的反应性关节炎,如生殖道感染(沙眼衣原体、解脲脲原体)或胃肠道感染(小肠结肠炎耶尔森菌、假结核耶尔森菌、福氏志贺菌、乙型副伤寒沙门菌、空肠弯曲菌)后的反应性关节炎外,作者们还讨论了在更宽泛的反应性关节炎定义中纳入链球菌感染后关节炎以及淋病奈瑟菌、脑膜炎奈瑟菌和布鲁氏菌感染后关节炎病例的可能性。反应性关节炎的临床病程并非总是良好。出现复发并进展为慢性炎性风湿病的情况并不罕见。

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