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. Author manuscript; available in PMC: 2010 Jul 23.
Published in final edited form as: Semin Arthritis Rheum. 2007 Mar 13;37(1):48–55. doi: 10.1016/j.semarthrit.2006.12.006

Table 3.

Incidence of acute reactive arthritis (ReA) following Campylobacter gastroenteritis

Source/Year of infection Cases of ReA/Cases of gastroenteritis [infective agent] Mean age (yrs) Comments
Gumpel, JM [64]
UK 1978		 8/33 (24%)
[serotypes not reported]		 NR

  • retrospective chart/data review of hospitalized pts

  • 6 of 8 developed mild rheumatic symptoms

  • 2 of 8 referred to rheumatology

  • symptom duration max 1 month
Kosunen, TU [27]
Finland 1978–1979		 8/342 (2.3%)
[C. jejuni]		 36

  • retrospective chart review/hospital data/clinical exams

  • time between onset of diarrhea and arthritis 7–28 days

  • ReA symptomatic for 7–17 weeks

  • arthralgia persisted for at least 21 months in 4 patients, 1 had a transient hydrops of the knee 6 months after arthritis disappeared
Pitkanen, T [52]
Finland 1978–1980		 3/55 (1.7%)
[C. jejuni]		 NR

  • hospital chart review/Q to patients with enteritis

  • 2 of 3 developed Re monoarthritis (HLA-B27 −)

  • 1 of 3 developed Re polyarthritis (HLA-B27 unknown)

  • symptom duration max 2 months
Johnsen, K [62]
Norway ‡ Early 1980’s		 5/37 (13.5%)
[C. jejuni]		 NR

  • 2 adults with classical Reiter’s syndrome

  • 3 children

  • 0% of HLA-B27+
Pönkä, A [53]
Finland 1979–1981		 6/283 (2.1%)
[C. jejuni]		 NR

  • Q to lab confirmed outpatients

  • N=524 (283 provided information about arthritis)

  • arthralgia reported in 54/282 (19%)

  • no further details about ReA
Pitkänen, T [56]
Finland 1978 – 1981		 9/188 (5%)
[C. jejuni]		 NR

  • 188 patients hospitalized for Campylobacter jejuni

  • Symptoms of sequlae determined by chart review and Q

  • 5% (n = 9) had arthritis; n = 6 (3%) of patients sought hospital care because of arthritis

  • Monoarthritis or polyarthritis occurred 1 to 3 wks after gastroenteritis; usually resolved within 6 mos
Melby, KK [87]
Norway 1988		 2/330 (0.6%)
[serotypes not reported for ReA cases]		 NR

  • O utbreak/Q to N=3085, responded N=520, GI symptomatic N=330

  • Responders:

    • Joint swelling in 21%

    • Arthralgia in 9%
Hannu, T [2]
Finland ‡ 1997–1998		 45/609 (7%)
[C. jejuni N=37 C. coli N=8]		 46

  • Large, population-based study of Campylobacter + stools/Q/+ evaluation by a rheumatologist

  • N=7 not clinically evaluated, described symptoms of ReA in the Q (ReA occurrence N=52 (9%) without clinical evaluation)

  • ReA:

    • 14% HLA-B27+ (similar to the Finnish general population)

    • 80% affected small joints

    • majority cases were poly-articular, mild and transient

  • 8/609 developed ReTEB

    • Report of enthesopathy associated with Campylobacter infection

  • GI symptomatology longer in pts with MSK symptomatology (vs those without)

  • No ReA in matched controls
Hannu, T [9]
Finland 2000		 9/350 (2.6%)
[C. jejuni]		 58

  • outbreak, 350 exposed subjects contacted the Health Centre/all acute MSK symptomatic pts referred to a rheumatologist within 3 months of outbreak

  • N=11, acute MSK symptomatology

    • N=9 ReA (all mild cases; oligo- N=6, poly-articular N=3; + 1 patient had also sacroiliitis; 33% HLA-B27 +)

    • N=2 reactive arthralgia

    • N=3 exacerbation of RA

    • N=1 exacerbation of fibromyalgia
Sieper, J for Leirisalo-Repo [88]
Finland		 Overall ReA frequency 16.1% NR

  • Community based study/Q/those with rheumatic symptoms evaluated further

  • Overall ReA frequency 16.1%

    • True arthritis 6.7%

    • Re sacroiliitis 2.3%

    • Re enthesitis 1.1%

    • Re “arthralgia/lumbalgia” 5.9%

NR, not reported; RA, rheumatoid arthritis; Re, reactive; ReTEB, reactive tendonitis, enthesopathy or bursitis; Q, questionnaire

‡

[67] At the population level, the frequency of ReA seems to be higher vs. post-outbreak Campylobacter ReA, have low association with HLA-B27 and arthritis seems to affect small joints.