Differentiation of PSRA due to Group A and due to Nongroup A Streptococci in Patients with Early Arthritis and Elevated Antisteptolysin-O at Presentation
Table 1
Overview of 45 patients with acute arthritis
subdivided into post-streptococcal reactive arthritis (PSRA) probably due to
group A streptococci (GAS) in 20, probably due to nongroup A streptococci
(NGAS) in 16, and 9 non-PSRA patients. Clinical data are taken at presentation;
maximum serological data are tabulated. Legend: IgM-RF = rheumatoid factor (IgM type), ANA = antinuclear antibodies.
PSRA
Presumed
GAS
Presumed NGAS
Non-PSRA
Number of
females/males
11/9
7/9
6/3
Mean age (SD)
in year [range]
33 (11) [17–54]
37 (17) [12–55]
40 (16) [14–70]
Positivity for
HLA-B27
1 (5%)
0
(0%)
0 (0%)
IgM-RF
1 (5%)
0 (0%)
5 (55%)
ANA
5
(25%)
0 (0%)
2 (22%)
Antistreptolysin-O (ASO)
200
20 (100%)
16 (100%)
6 (67%)
mean value (SEM)
1390 (235)
1055 (130)
1088 (360)
Antideoxyribonuclease-B
(ADB)
200
20 (100%)
2 (12.5%)
6 (67%)
mean value (SEM)
2730 (450)
295 (67)
340 (90)
ASO/ADB ratio
1.4
20 (100%)
0 (0%)
3 (33%)
mean value (SEM)
0.62 (0.06)
6.2 (1.2)
9.4 (5.0)
Positive throat
culture
7x GAS
2x NGAS
1x NGAS
Arthritic
joints; mean number (SEM)
5.2 (1.3)*
1.9 (0.4)
3.4 (1.2)
monoarthritis
8 (40%)
10 (63%)
3 (33%)
oligoarthritis
7 (35%)
5 (32%)
3 (33%)
polyarthritis
5 (25%)
1 (6%)
3 (33%)
Mean duration in weeks (SD)
25 (10)*
5 (2.5)
—
exceeding 2 months
10 (50%)
5 (31%)
—
exceeding 6 months
5 (25%)
0 (0%)
—
Pericarditis
1 (5%)
0 (0%)
0 (0%)
Pneumonitis
1 (5%)
0 (0%)
0 (0%)
Erythema
nodosum/multiforme
1 (5%)
0
(0%)
1 (11%)
Cholestatic
hepatitis
2
(10%)
0 (0%)
0 (0%)
Tenosynovitis
4 (20%)
0 (0%)
3 (33%)
-value <.05 for
comparison presumed GAS-induced and presumed NGAS-induced PSRA patients. GAS no.
is presumed as the causative organism if the ASO/antiDNaseB ratio is <1.4;
NGAS is presumed if ASO/antiDNaseB ratio >1.5.
