Рецепт. 2019; 22: 877-885
Современный взгляд на вопросы диагностики и лечения реактивных артритов
Аннотация
Проблема диагностики и лечения реактивных артритов является мало разработанным вопросом. До сегодняшнего дня нет единой точки зрения ревматологов Европы на методы выявления инфекции-триггера, варианты клинических форм и длительность лечения заболевания. Не учитываются внесуставные проявления и их влияние на продолжительность терапии. Не отслеживаются отдаленные последствия и прогноз течения болезни. Классификационные критерии реактивных артритов выработаны международным экспертным советом (Берлин 1999 г.). С момента их обсуждения прошло более 20 лет. Накопилась новая информация о клинических проявлениях и методах лечения этой патологии, учтены результаты 15-летнего труда многочисленных сотрудников 2-й кафедры внутренних болезней БГМУ, ревматологов 9-й ГКБ и МДЦ, МНПЦ ХТиГ.
Статья посвящена вопросам актуальности и трудностям диагностики и лечения реактивных хламидиоиндуцированных артритов, новому взгляду на подходы к терапии пациентов с различными вариантами клинических проявлений и характером течения заболевания.
Список литературы
1. Sibilia J. (2002) Reactive arthritis or chronic infectious arthritis? Ann. Rheum. Dis., vol. 61, no 7, pp. 580–587.
2. Sokka T. (2004) Reactive arthritis. Clinical Cuidans from ASR. Pier.
3. Braun J. (2000) On the difficulties of definition of and diagnostic investigations for reactive arthritis. Results and discussion of a questionnaire prepared for the 4 th international Workshop on Reactive Arthritis, Berlin, July 3–6, 1999. Rheumatology, vol. 27, no 9, pp. 2185–2192.
4. Carter J.D., Espinoza L.R., Inman R.D. (2010) Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double-blind, placebo-controlled, prospective trial. Arthritis Rheum., vol. 62, pp. 1298–307.
5. Rihl M., Kuipers J.G., Köhler L. (2010) Combination antibiotics for Chlamydia-induced arthritis: breakthrough to a cure? Arthritis Rheum, vol. 62, pp. 1203–7.
6. Zeidler H., Calin A., Amor B. (2011) A historical perspective of the spondyloarthritis. Curr Opin Rheumatol, vol. 23, pp. 327–33.
7. Morris D., Inman R.D. (2012) Reactive Arthritis: Developments and Challenges in Diagnosis and Treatment. Curr Rheumatol Rep., vol. 14, pp. 390–4.
8. Schumacher H.R. Jr. (2000) Chlamydia-associated reactive arthritis. Isr Med Assoc J., vol. 2, pp. 532–5.
9. Gérard H.C., Whittum-Hudson J.A., Carter J.D. (2010) The pathogenic role of Chlamydia in spondyloarthritis. Curr Opin Rheumatol., vol. 22, pp. 363–7.
10. Ozgül A., Dede I., Taskaynatan M.A. (2006) Clinical presentations of chlamydial and nonchlamydial reactive arthritis. Rheumatol Int., vol. 26, pp. 879–85.
11. Savolainen E., Kettunen A., Närvänen A. (2009) Prevalence of antibodies against Chlamydia trachomatis and incidence of C. trachomatis-induced reactive arthritis in an early arthritis series in Finland in 2000. Scand J Rheumatol., vol. 8, pp. 353–6.
12. Tkachuk V., Luk’yanov A., Noskov N. (2007) Mesto sistemnoi enzimoterapii v kompleksnom lechenii bol’nih hronicheskim prostatitom [Place of systemic enzyme therapy in complex treatment of patients with chronic prostatitis]. Vrachebnoe soslovie, 2–7.
Recipe. 2019; 22: 877-885
Modern Look at the Diagnosis and Treatment of Reactive Arthritis
Abstract
The problem of diagnosing and treating reactive arthritis is a little-developed issue. Until today, there is no single point of view of rheumatologists in Europe on the methods of application of the trigger infection, clinical options and the duration of treatment of diseases. The introduced changes and their effect on the duration of therapy are not taken into account. Long-term effects and disease prognosis are not monitored. The classification criteria for reactive arthritis are based on those developed by an international expert council (Berlin 1999). More than 20 years have passed since their development. New information has accumulated on the clinical manifestations and methods of treating this pathology, the results of 15 years of work by a large team of employees of the 2nd Department of Internal Medicine BSMU, rheumatologists of the 9th City Clinical Hospital and the MDC, MNPC ST and H are taken into account.
The article is devoted to the relevance and tediousness of the diagnosis and treatment of reactive Chlamydia-induced arthritis, a new look at the treatment approaches of patients with various clinical manifestations and the nature of the course of the disease.
References
1. Sibilia J. (2002) Reactive arthritis or chronic infectious arthritis? Ann. Rheum. Dis., vol. 61, no 7, pp. 580–587.
2. Sokka T. (2004) Reactive arthritis. Clinical Cuidans from ASR. Pier.
3. Braun J. (2000) On the difficulties of definition of and diagnostic investigations for reactive arthritis. Results and discussion of a questionnaire prepared for the 4 th international Workshop on Reactive Arthritis, Berlin, July 3–6, 1999. Rheumatology, vol. 27, no 9, pp. 2185–2192.
4. Carter J.D., Espinoza L.R., Inman R.D. (2010) Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double-blind, placebo-controlled, prospective trial. Arthritis Rheum., vol. 62, pp. 1298–307.
5. Rihl M., Kuipers J.G., Köhler L. (2010) Combination antibiotics for Chlamydia-induced arthritis: breakthrough to a cure? Arthritis Rheum, vol. 62, pp. 1203–7.
6. Zeidler H., Calin A., Amor B. (2011) A historical perspective of the spondyloarthritis. Curr Opin Rheumatol, vol. 23, pp. 327–33.
7. Morris D., Inman R.D. (2012) Reactive Arthritis: Developments and Challenges in Diagnosis and Treatment. Curr Rheumatol Rep., vol. 14, pp. 390–4.
8. Schumacher H.R. Jr. (2000) Chlamydia-associated reactive arthritis. Isr Med Assoc J., vol. 2, pp. 532–5.
9. Gérard H.C., Whittum-Hudson J.A., Carter J.D. (2010) The pathogenic role of Chlamydia in spondyloarthritis. Curr Opin Rheumatol., vol. 22, pp. 363–7.
10. Ozgül A., Dede I., Taskaynatan M.A. (2006) Clinical presentations of chlamydial and nonchlamydial reactive arthritis. Rheumatol Int., vol. 26, pp. 879–85.
11. Savolainen E., Kettunen A., Närvänen A. (2009) Prevalence of antibodies against Chlamydia trachomatis and incidence of C. trachomatis-induced reactive arthritis in an early arthritis series in Finland in 2000. Scand J Rheumatol., vol. 8, pp. 353–6.
12. Tkachuk V., Luk’yanov A., Noskov N. (2007) Mesto sistemnoi enzimoterapii v kompleksnom lechenii bol’nih hronicheskim prostatitom [Place of systemic enzyme therapy in complex treatment of patients with chronic prostatitis]. Vrachebnoe soslovie, 2–7.
