Reactive arthritis following Salmonella infection: a population-based study. (May 2013)

• Record Type: Journal Article
• Authors: Tuompo, R; Hannu, T; Mattila, L; Siitonen, A; Leirisalo-Repo, M
• Is Part Of: Scandinavian journal of rheumatology. Volume 42:Number 3(2013)
• Page Start: 196
• Page End: 202
• Publication Date: 2013-05
• Subjects: Rheumatology -- Periodicals; Arthritis; Rheumatic Diseases; 616.72005
• DOI: 10.3109/03009742.2012.739201
• Languages: English
• ISSNs: 0300-9742

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>Objectives:</bold> To study the incidence and clinical picture of <italic>Salmonella</italic>-associated reactive arthritis (ReA), as well as other reactive musculoskeletal symptoms and the arthritogenicity of various <italic>Salmonella enterica</italic> ssp<italic>. enterica</italic> serotypes in the population.</p> <p> <bold>Method:</bold> We sent a questionnaire on enteric and extraintestinal (especially musculoskeletal) symptoms to 999 consecutive subjects with a <italic>Salmonella</italic>-positive stool culture. Analysis of self-reported musculoskeletal symptoms was supplemented with a clinical examination of subjects with recent symptoms.</p> <p> <bold>Results:</bold> Of the 999 <italic>Salmonella</italic>-positive subjects, 496 (50%) returned the questionnaire. Of these, 4.4% (22/496) had ReA and 13.7% (68/496) had other reactive musculoskeletal symptoms [tendinitis, enthesopathy, or bursitis (ReTe)]. Among the ReA patients, all adults, <italic>Salmonella</italic> Enteritidis was the most common causative serotype. The clinical picture of patients with ReA was mostly monoarticular or oligoarticular. Human leucocyte antigen (HLA)-B27 was positive in 42% of patients with ReA. The <italic>Salmonella</italic> O antigens of the 496 subjects belonged to eight groups (B, C, D1, E, G, I, L, and O), all with different major O antigenic determinants. All 22 patients with ReA and all 68 patients with ReTe were in O antigen groups B, C, D1, or E. However, the occurrence of musculoskeletal complications showed no statistically significant difference in relation to different O antigen groups (p = 0.69).</p> <p> <bold>Conclusions:</bold> ReA occurred in 4.4% of patients after <italic>Salmonella</italic> infection, with an annual incidence of 1.8/100 000 in Finland. We found no differences in arthritogenicity between different <italic>Salmonella</italic> serotypes that trigger musculoskeletal complications.</p> </abstract>