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A Case of Poststreptococcal Reactive Arthritis
Eun-Ha Park, M.D., Yeun Sil Do, M.D., Jeong-Chae Yang, M.D., Mira Kang, M.D., Hyun Joo Suh, M.D., Sook-In Jung, M.D. Jun Seong Son, M.D., Hyun Kyun Ki, M.D., Won Sup Oh, M.D., Kyong Ran Peck, and Jae-Hoon Song, M.D.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Vol.36 Num.6 (p389~393)
Poststreptococcal reactive arthritis (PSRA) is associated with recent streptococcal infections. However, PSRA is distinct from acute rheumatic fever by its clinical manifestations: non-migrating arthritis, erythema nodosum or erythema multiforme, and transient elevation of serum transaminases. We experienced a 33-year-old man who presented with fever, arthritis of both knees and ankles, and erythema nodosums on extensor surfaces of lower legs which developed 6 days after the onset of pharyngitis symptoms. Blood and urine cultures were negative. Throat culture was negative for group A ?-hemolytic streptococcus. The ASO titers increased up to 2080 IU/mL in sequential monitoring. The result of bone scan was compatible to arthritis of both knees and ankles. There were no signs or symptom of carditis. He showed clinical improvement with anti-inflammatory drugs (naproxen 1,000 mg/day and prednisolone 7.5 mg/d). PSRA should be included in the differential diagnosis of patients presenting with arthritis combined with fever.
Keywords : Poststreptococcal reactive arthritis, Streptococcal infection, Rheumatic fever