Yersinosis-related reactive arthritis: diagnostic and treatment constraints (individual experience)

Reactive arthritis (ReA) remains an important problem in the practice of rheumatology, and is one of the most common types of acute arthritis in young people. The relevance of ReA is due to its high frequency, difficulties of diagnosis, a chronicity with an insufficiently effective treatment. The article discusses current literature data on Yersinia arthritis, features of pathogenesis, diagnosis and treatment. The occurrence of ReA is most often associated with gastrointestinal or urogenital infection, which precedes the development of joint syndrome. Among the ReAs associated with intestinal infection, Yersinia is quite common. Intestinal yersiniosis is severe, has a significant duration with a tendency to chronicity, involvement of various organs and systems in the pathological process. The features of Yersiniosis pathogens in combination with infectious conditions cause a wide variety of clinical manifestations. The disease has a frequent association with HLA-B27 antigen. Among the common clinical symptoms of ReA there are asymmetric arthritis of the lower extremities, sausage-like toe deformity, tendonitis, enthesitis (most commonly heel tendon enthesitis), and asymmetric sacroiliitis. The frequency and severity of extra-articular manifestations may be different: lesions of the eyes, skin, mucous membranes, urogenital or gastrointestinal tract. First-line drugs in the treatment of ReA are NSAIDs. Patients with an active source of infection also require a long-term treatment with antibacterial therapy, sulfosalazine is added in case of a chronic arthritis. The article presents a clinical case of Yersiniosis reactive arthritis, emphasizes the multidisciplinary approach in the management of the patient.