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Differentiation of PSRA due to Group A and due to Nongroup A Streptococci in Patients with Early Arthritis and Elevated Antisteptolysin-O at Presentation

Author(s): T. L. Th. A. Jansen

Journal: International Journal of Rheumatology
ISSN 1687-9260

Volume: 2009;
Date: 2009;
Original page

A study was performed of consecutive patients presenting to a Dutch early arthritis clinic with a primary suggested diagnosis of reactive arthritis due to streptococci between April 1998 and January 2003, in a well-defined reference population consisting of 600 000 inhabitants. At 1 year after presentation out of 45 acute arthritis patients with initially an elevated antistreptolysin-O and without an alternative rheumatic diagnosis only 9 patients (20%) were not diagnosed as PSRA; 16 cases (36%) were due to NGAS, 20 cases (44%) due to GAS. The estimate of the annual incidence rate of PSRA in the Netherlands during the study was 1.26 per 100 000: 0.70 GAS-related. A diagnostic set of criteria was formulated based on the original Ayoub&Ahmed criteria by adding a serological criterium ASO/antiDNaseB ratio
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