PSRA is an inflammatory joint condition that can develop after a person recovers from strep throat. Aside from typical features of arthritis, other symptoms can include nodules in the skin and inflammation of the kidneys and eyes.
Treatment may entail nonsteroidal anti-inflammatory drugs (NSAIDs) and possibly antibiotics. A complication of PSRA is carditis or inflammation of the heart.
This article discusses PSRA, including its symptoms, diagnosis, treatment, complications, and duration. It also examines PSRA versus rheumatoid arthritis.
PSRA is arthritis in
This type of arthritis typically
In an interview with Medical News Today, Dr. Isabelle Amigues, founder of UnabridgedMD, adds that PSRA is an autoimmune response to GAS. Autoimmune means the immune system attacks the body’s healthy tissues, leading to various symptoms.
How common is PSRA?
PRSA is uncommon. Approximately
Arthritis symptoms can vary and can be very painful. The pattern of arthritis varies; it can affect one or many joints at once and joints on both sides of the body. Another form of arthritis called dactylitis can cause swelling of the whole finger or toes.
PSRA is less likely to lead to residual joint damage or deformities.
Morning stiffness and nighttime pain are also typical.
- erythema nodosum — which are red, tender, raised nodules deep in the skin
- glomerulonephritis — inflammation of a kidney
- uveitis — inflammation of the middle layer of eye tissues
Other non-joint symptoms, such as carditis (heart inflammation) can occur.
How long does PSRA last?
Although a throat infection with GAS may cause PSRA, it can also cause a similar condition called acute rheumatic fever (ARF). Sometimes, doctors find it challenging to make a differential diagnosis between the two conditions.
Amigues explains the distinguishing features:
- PSRA develops in 1–2 weeks after the infection, as opposed to 4–5 weeks in ARF.
- The response to treatment with anti-inflammatory drugs is less obvious with PSRA.
- Markers of inflammation are lower than with PSRA.
- While the two conditions have symptoms in common, they have some differences.
- PSRA arthritis tends to be
more prolongedthan arthritis in ARF.
“Doctors endeavor to diagnose PSRA when it occurs, but it may actually be a milder form of ARF,” adds Amigues.
“Once we confirm a diagnosis of PSRA, if NSAIDs do not provide enough symptom relief, we may recommend some biologic agents,” said Amigues. “These may entail tumor necrosis factor (TNF) inhibitors, such as adalimumab (Humira).” TNF inhibitors reduce inflammation in autoimmune conditions.
“There are instances when it is not absolutely clear whether someone has PSRA or ARF,” added Amigues. “In these cases, some doctors favor prescribing antibiotics for 1– 2 years after the onset of symptoms to help prevent delayed-onset carditis. Carditis is a complication of PSRA and ARF. The purpose of antibiotics is to eradicate the GAS infection from the throat.”
“Afterward, these people will get a cardiac evaluation with an echocardiogram — a heart function test,” continued Amigues. “If this shows no heart abnormality, we can discontinue the antibiotics.”
Aside from drug treatment, doctors may also
- Balance of exercise and rest: Exercise can increase and maintain muscle strength and keep the joints moving and flexible.
- Assistive devices: These may include a walker or cane to make it easier for a person to move around.
- Cold and heat therapies: These interventions may reduce pain.
- Braces or shoe inserts: These can help an individual stand and walk because they provide support and may decrease pain.
“The most dreaded complication of PSRA is carditis, which can cause inflammation in the heart valves and result in heart failure,” said Amigues. “Heart failure is the inability of the heart to pump adequately to supply circulation to the body.”
“Sometimes people do not appear to have a definite diagnosis of either PSRA or ARF,” said Amigues. “When this happens, they need an evaluation by rheumatology. Indeed, we need to ensure that the symptoms are due to reactive arthritis and not some other type of inflammatory arthritis, such as rheumatoid arthritis.”
Rheumatoid arthritis can cause similar symptoms in the joints, such as:
- morning stiffness
Additionally, like PSRA, rheumatoid arthritis may affect the eyes and heart. However, unlike PSRA, rheumatoid arthritis can involve other parts of the body, including:
- blood vessels
PSRA is an autoimmune response to a strep throat infection that manifests within
The symptoms that can affect one or more joints include swelling and pain. They may also involve the skin, kidneys, and eyes.
Diagnosis may pose a challenge because a GAS infection may also cause ARF, which is similar to PSRA.
Treatment entails NSAIDs and may include antibiotics. The mean duration of the condition is
A person who develops arthritis shortly after recovering from strep throat should see a doctor for further assessment.