Health

Current theory for the pathogenesis of a postenteritic reactive arthritis Bacterial lipopolysaccharide antigens (but not viable organisms or nucleotides) from the pathogens ( Yersinia, Shigella, Salmonella ) causing the infectious gastroenteritis have been shown to be deposited in the joints of patients who develop a postenteritic reactive arthritis. These bacterial cell wall components are thought to incite …

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Relationship of HLA-B27 positivity in patients with postenteritic reactive arthritis compared with a normal healthy population Reactive arthritis patients, 60% to 80% HLA-B27 positive; normal healthy controls, 4% to 8% HLA-B27 positive. Caucasians and patients with radiographic sacroiliitis or uveitis are more likely to be HLA-B27 positive. A person who is HLA-B27 positive has a 30 to 50 times increased risk of developing reactive arthritis …

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How do the radiographic features of inflammatory sacroiliitis and spondylitis caused by postenteritic reactive arthritis differ from those in IBD patients? Radiologic Comparison of Spinal Arthritis in Postenteritic Reactive Arthritis Versus Inflammatory Bowel Disease Reactive Arthritis IBD Sacroiliitis Unilateral, asymmetric Bilateral, sacroiliac involvement Spondylitis Asymmetric, nonmarginal, jug-handle syndesmophytes Bilateral, thin, marginal syndesmophytes IBD, Inflammatory bowel disease.

What extraarticular manifestations can occur in patients with postenteritic reactive arthritis? Sterile urethritis (15% to 70%) Conjunctivitis Acute anterior uveitis (iritis) Oral ulcers (painless or painful) Erythema nodosum (5% of Yersinia infections) Circinate balanitis Keratoderma blennorrhagicum

Clinical characteristics of postenteritic reactive arthritis Demographically, males are affected more frequently than females; average age is 30 years old. Onset of arthritis is abrupt and acute. Distribution of joints is asymmetric and oligoarticular. A lower extremity is involved in 80% to 90%. Sacroiliitis occurs in 20% to 30%; enthesitis (Achilles tendon, plantar fascia attachments) …

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Why are patients with IBD more prone to develop an inflammatory arthritis?  The pathogenesis of gut-joint iteropathy is unknown. However, inflammation of the gut and joints appear to be tightly linked. When ileocolonoscopies are done on spondyloarthropathy (ankylosing spondylitis, reactive arthritis) patients without GI symptoms, up to 25% have macroscopic lesions and up to 60% …

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What rheumatic disorders are associated with pouchitis, lymphocytic colitis (LC), and collagenous colitis (CC)?  Pouchitis is inflammation of the ileal pouch created following colectomy for UC. It occurs in up to 40% to 60% of patients having this surgery. Patients present with watery or bloody diarrhea. Some develop arthritic manifestations. Treatment includes metronidazole and ciprofloxacin. …

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