Poststreptococcal Reactive Arthritis in Children: A Serial Case
Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.
[1] Uziel Y, Perl L, Barash J, Hashkes J. Post-streptococcal reactive arthritis in children:a distinct entity from acute rheumatic fever. Pediatr Rheumatol. 2011, 9, pp. 32-8.
[2] Gerber MA. Group A streptococcus. In: Kliegmen RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatry. 18th ed. Philadelphia: Saunders Elsevier; 2007, pp. 1135-44.
[3] Mackie SL, Keat A. Poststreptococcal reactive arthritis: what is it and how do we know?. Rheumatology. 2004, 43, pp. 949-54.
[4] Barash J, Mashiac E, Navon-Elkan P, Berkun Y, Harel L, Tauber T, et al. Differentiation of post-streptococcal reactive arthritis from acute rheumatic fever. J Pediatr. 2008, 153, pp. 696-9.
[5] De Cunto CL, Gianini EH, Fink CW, Brewer EJ, Person DA. Prognosis of children with poststreptococcal reactive arthritis. J Pediatr Infect Dis. 1998, 7, pp. 683-6.
[6] Malleson PN. Management of childhood arthritis. Part 1: acute arthritis. Arch Dis Child. 1997, 76, pp. 460-2.
[7] Keat A. Reactive arthritis or post-infective artritis?. Best Pract Res Clin Rheumatol. 2002, 16, pp. 507-22.
[8] Jansen TL, de Jong AJ, Jeurissen ME. Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever. J Intern Med. 1999, 142, pp. 261-7.
[9] Walker MJ, Barnett TC, McArthur JD, Cole JN, Gillen CM, Henningham A, et al. Disease manifestations and pathogenic mechanisms of group A streptococcus. Clin Microbiol Rev. 2014, pp. 264-301.
[10] Madeleine W, Cunningham. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev. 2000, 13, pp. 470-511.
[11] Fieber C, Kovarik P. Responses of innate immune cell to group A streptococcus. Front Cell Infect Microbiol. 2014, 4, pp. 140-7.
[12] RG, Forman TA. Evaluation of poststreptococcal illness. Am Fam Physician. 2005, 71, pp. 1949-54.
[13] Taylor JE, Ross DA, Goodacre JA. Group A streptococcal antigens and superantigens in the pathogenesis of autoimmune arthritis. European Journal of Clinical Investigation. 1994, 24, pp. 511-21.
[14] Odete M, Teresa M. Rheumatic fever and post-streptococcal arthritis. Best Pract Res Clin Rheumatol. 2002, 16, pp. 481-94.
[15] Brian T, Wipke ZW, Wouter N, David E, Paul M. Staging the initiation of role for immune complexes autoantibody-induced arthritis: a critical role of immune complex. J Immunol. 2004, 172, pp. 7694-702.
[16] Birdi N, Hosking M, Clulow MK, Duffy CM, Allen U, Petty RE. Acute rheumatic fever and poststreptococcal reactive arthritis: diagnostic and treatment practices of pediatric subspecialists in Canada. J Rheumatol. 2001, 28, pp. 1681-8.
[17] Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST, et al. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis. Pediatrics. 2009, 119, pp. 1541-51.
[18] Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics. 2004, 113, pp. 866-82.
[19] Schaffer FM, Agarwal R, Helm J, Gingell RL, Roland JM, O’Neil KM. Poststreptococcal reactive arthritis and silent carditis: a case report and review of the literature. Pediatrics. 1994, 93, pp. 837-9.
[1] Uziel Y, Perl L, Barash J, Hashkes J. Post-streptococcal reactive arthritis in children:a distinct entity from acute rheumatic fever. Pediatr Rheumatol. 2011, 9, pp. 32-8.
[2] Gerber MA. Group A streptococcus. In: Kliegmen RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatry. 18th ed. Philadelphia: Saunders Elsevier; 2007, pp. 1135-44.
[3] Mackie SL, Keat A. Poststreptococcal reactive arthritis: what is it and how do we know?. Rheumatology. 2004, 43, pp. 949-54.
[4] Barash J, Mashiac E, Navon-Elkan P, Berkun Y, Harel L, Tauber T, et al. Differentiation of post-streptococcal reactive arthritis from acute rheumatic fever. J Pediatr. 2008, 153, pp. 696-9.
[5] De Cunto CL, Gianini EH, Fink CW, Brewer EJ, Person DA. Prognosis of children with poststreptococcal reactive arthritis. J Pediatr Infect Dis. 1998, 7, pp. 683-6.
[6] Malleson PN. Management of childhood arthritis. Part 1: acute arthritis. Arch Dis Child. 1997, 76, pp. 460-2.
[7] Keat A. Reactive arthritis or post-infective artritis?. Best Pract Res Clin Rheumatol. 2002, 16, pp. 507-22.
[8] Jansen TL, de Jong AJ, Jeurissen ME. Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever. J Intern Med. 1999, 142, pp. 261-7.
[9] Walker MJ, Barnett TC, McArthur JD, Cole JN, Gillen CM, Henningham A, et al. Disease manifestations and pathogenic mechanisms of group A streptococcus. Clin Microbiol Rev. 2014, pp. 264-301.
[10] Madeleine W, Cunningham. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev. 2000, 13, pp. 470-511.
[11] Fieber C, Kovarik P. Responses of innate immune cell to group A streptococcus. Front Cell Infect Microbiol. 2014, 4, pp. 140-7.
[12] RG, Forman TA. Evaluation of poststreptococcal illness. Am Fam Physician. 2005, 71, pp. 1949-54.
[13] Taylor JE, Ross DA, Goodacre JA. Group A streptococcal antigens and superantigens in the pathogenesis of autoimmune arthritis. European Journal of Clinical Investigation. 1994, 24, pp. 511-21.
[14] Odete M, Teresa M. Rheumatic fever and post-streptococcal arthritis. Best Pract Res Clin Rheumatol. 2002, 16, pp. 481-94.
[15] Brian T, Wipke ZW, Wouter N, David E, Paul M. Staging the initiation of role for immune complexes autoantibody-induced arthritis: a critical role of immune complex. J Immunol. 2004, 172, pp. 7694-702.
[16] Birdi N, Hosking M, Clulow MK, Duffy CM, Allen U, Petty RE. Acute rheumatic fever and poststreptococcal reactive arthritis: diagnostic and treatment practices of pediatric subspecialists in Canada. J Rheumatol. 2001, 28, pp. 1681-8.
[17] Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST, et al. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis. Pediatrics. 2009, 119, pp. 1541-51.
[18] Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics. 2004, 113, pp. 866-82.
[19] Schaffer FM, Agarwal R, Helm J, Gingell RL, Roland JM, O’Neil KM. Poststreptococcal reactive arthritis and silent carditis: a case report and review of the literature. Pediatrics. 1994, 93, pp. 837-9.
@article{"International Journal of Medical, Medicine and Health Sciences:74421", author = "A. Lubis and S. S. Pasulu and Z. Hikmah and A. Endaryanto and A. Harsono", title = "Poststreptococcal Reactive Arthritis in Children: A Serial Case", abstract = "Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.
", keywords = "Arthritis, group A streptococcus, autoantibody, Jones criteria.", volume = "10", number = "12", pages = "571-8", }
