Rheumatology International

, Volume 27, Issue 1, pp 111–113 | Cite as

HLA-DR alleles in patients with post-streptococcal reactive arthritis

  • Filiz Ekşi Haydardedeoğlu
  • Hüseyin Tutkak
  • Kenan Köse
  • Nurşen DüzgünEmail author
Letter to the Editor


Reactive arthritis is a term used to describe a sterile inflammatory arthritis occurring after a documented infection elsewhere in the body. Infections of the gastrointestinal, genitourinary and respiratory tract appear to provoke reactive arthritis. Acute rheumatic fever (ARF) and post-streptococcal reactive arthritis (PSReA) are the known complications of streptococcal throat infections. Not all patients infected with streptococcus causing pharyngitis result in with ARF as well as PSReA. ARF develops in 2–3% of children/adolescents infected with group A β-haemolytic streptococci causing pharyngitis. Main manifestations of ARF include carditis, migratory polyarthritis, cutaneous signs, chorea and subsequent acquired valvular disease. PSReA appeared different from that of acute rheumatic fever (ARF) and from that of HLA B27-associated reactive arthritis [1, 2, 3]. However, PSReA shares some features with ARF and with HLA B27-related spondyloarthropathies. Clinical features of the...


Post-streptococcal reactive arthritis HLA-DR alleles 



This work was supported by a research grant from Ankara University, No:2003 08 09 119.


  1. 1.
    Schulman ST, Ayoub EM (2002) Poststreptococcal reactive arthritis. Curr Opin Rheumatol 14:562–565CrossRefGoogle Scholar
  2. 2.
    Keitzer R (2005) Acute rheumatic fever (ARF) and poststreptococcal reactive arthritis(PSRA); an update Zeitschrift für. Rheumatologie 64(5):295–307CrossRefGoogle Scholar
  3. 3.
    Ayoub EM, Majeed HA (2001) Poststreptococal reactive arthritis. Curr Opin Rheumatol 12:306–310CrossRefGoogle Scholar
  4. 4.
    Geasch WH (1992) Guidelines for the diagnosis of rheumatic fever Jones Criteria update. JAMA 268(15):2069–2073CrossRefGoogle Scholar
  5. 5.
    Jansen TLJ, Anssen M, de Jong AJ, Jeurissen MA (1999) Post-streptococcal reactive arthritis: a clinical and serological description, revealing its distinction from acute rheumatic fever. J Intern Med 245(3):261–267PubMedCrossRefGoogle Scholar
  6. 6.
    Mackie SL, Keat A (2004) Poststreptococcal reactive arthritis: what is it and how do we know? Rheumatology (Oxford) 43(8):949–954CrossRefGoogle Scholar
  7. 7.
    Carlquist JF, Ward RH, Meyer KJ, Husebye D, Feolo M, Anderson JL (1995) Immune response factors in rheumatic heart disease: meta-analysis of HLA-DR associations and evaluation of additional class II alleles. J Am Coll Cardiol. 26(2):452–457PubMedCrossRefGoogle Scholar
  8. 8.
    Koyanagi T, Koga Y, Nishi H, Toshima H, Sasazuki T (1996) DNA typing of HLA class II genes in Japanese patients with rheumatic heart disease. J Mol Cell Cardiol 28(6):1349–1353PubMedCrossRefGoogle Scholar
  9. 9.
    Guedez Y, Kotby A, El-Demellawy M, Galal A,Thomson G, Zaher S et al (1999) HLA Class II association with rheumatic heart disease are more evident and consistent among clinically homogenous patients. Circulation 99:2784–2790PubMedGoogle Scholar
  10. 10.
    Ahmed S, Ayoub EM, Scornick JC, Wang CY, She JX. (1998) Poststreptococcal reactive arthritis; clinical characteristics and association with HLA-DR alleles. Arthritis Rheum 41:1092–1102CrossRefGoogle Scholar
  11. 11.
    Simonini G, Porfirio M, Cimaz R, Calabri G B, Giani T, Falcini F (2004) Lack of association between the HLA-DRB1 locus and post-streptococcal reactive arthritis and acute rheumatic fever in Italian children. Semin Arthritis Rheum 34(2):553–558PubMedCrossRefGoogle Scholar
  12. 12.
    Miller SA, Dykes DD, Polesky HF (1988) A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res 16:1215PubMedGoogle Scholar
  13. 13.
    Olerup O, Zetterquist H (1992) HLA-DR typing by PCR amplification with sequence primers (PCR-SSP) in 2 hours: an alternative to serological DR typing in clinical practice including donor-recipient matching. Tissue Antigens 39:235–245CrossRefGoogle Scholar
  14. 14.
    Woolf B (1955) On estimating the relation between blood group and disease. Ann Hum Genet 19:251–253PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Filiz Ekşi Haydardedeoğlu
    • 1
  • Hüseyin Tutkak
    • 1
  • Kenan Köse
    • 2
  • Nurşen Düzgün
    • 1
    Email author
  1. 1.Department of Clinical Immunology and RheumatologyAnkara University School of MedicineAnkaraTurkey
  2. 2.Department of BiostatisticAnkara University School of MedicineAnkaraTurkey

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