Retke respiratorne infekcije kao uzročnici reaktivnog artritisa

Revijski rad

Saša Janjić, Ana Đokić, Milena Đokić, Ana Marković, Anđela Peruničić, Tatjana Dimić, Mirjana Zlatković Švenda, Slavica Pavlov Dolijanović

35–42

https://doi.org/10.5937/medrec2601035J

ORCID iDs:             Saša Janjić                            N/A
Ana Đokić                       https://orcid.org/0009-0007-9937-0739
Milena Đokić                    https://orcid.org/0009-0009-2410-336­6
Ana Marković                    https://orcid.org/0009-0004-9828-1839
Anđela Peruničić                https://orcid.org/0009-0009-4645-6074
Tatjana Dimić                   https://orcid.org/0009-0002-5969-3676
Mirjana Zlatković Švenda https://orcid.org/0000-0002-7123-140X
Slavica Pavlov Dolijanović. https://orcid.org/0009-0005-5683-2193

Apstrakt

Reaktivni artritis (ReA) predstavlja imunski posredovan, aseptičan artritis koji može da nastane u periodu od 3 dana do 6 nedelja nakon bilo koje ekstra-artikularne infekcije. Iako je najčešće precipitiran gastrointestinalnom ili genitourinarnom infekcijom, nakon pandemije SARS-CoV-2 sve veći značaj u nastanku ovog oboljenja se pridaje i respiratornim uzročnicima. Zbog toga, cilj ovog preglednog rada je da prikaže savremena saznanja o retkim respiratornim uzročnicima ReA, sa osvrtom na njihov klinički značaj i dijagnostičko-terapijske implikacije. Sprovedeno je sistematsko pretraživanje relevantne naučne literature, koristeći Medline bazu podataka, sa posebnim osvrtom na period od 2020. do 2025. godine, sa ciljem identifikacije i analize slučajeva ReA nastalih u kontekstu respiratorne infekcije, izazvane prvenstveno retkim respiratornim uzročnicima. U okvir analize, uključeni su pojedinačni prikazi slučajeva, originalni naučni radovi i pregledni članci. Najčešće identifikovani respiratorni uzročnici bili su: SARS-CoV-2, Chlamydophila pneumoniae, Streptococcus pyogenes, Parvovirus-B19 i Mycoplasma pneumoniae, sa varijabilnim vremenskim intervalom između infekcije i pojave artritisa (od nekoliko dana do više nedelja). Ređi respiratorni uzročnici bili su: Streptococcus pneumoniae, Neisseria meningitidis, Rothia mucilaginosa, Haemophilus influenzae i Mycobacterium tuberculosis. Klinička slika ReA izazvanog ovim patogenima nije se značajno razlikovala od one uobičajene etiologije, ali su zapažene razlike u dužini trajanja simptoma i odgovoru na terapiju. U većini slučajeva, artritis je bio oligoartikularan, asimetričan i praćen sistemskim znacima upale. Terapijski pristupi uključivali su nesteroidne antiinflamatorne lekove, kortikosteroide, kao i u pojedinim slučajevima, antibiotike i imunosupresive. ReA izazvan retkim respiratornim patogenima predstavlja dijagnostički izazov, jer iako su ovi uzročnici ređe identifikovani, njihova uloga u etiopatogenezi ReA zahteva dodatnu pažnju, s obzirom na potencijalno atipičan tok bolesti i potrebu za individualizovanim terapijskim pristupom. Ograničen broj dostupnih prikaza slučajeva i druge naučne literature ukazuje na potrebu za daljim istraživanjima i standardizacijom dijagnostičkih kriterijuma u ovom domenu.

Ključne reči: reaktivni artritis, retki respiratorni patogeni, postinfektivni artrtis

Ceo tekst 

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