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Arthritis und Rheuma 2022; 42(02): 85-92
DOI: 10.1055/a-1762-1930
Schwerpunkt

Virusassoziierte Arthritiden

Virus-associated arthritis
Ioana Andreica
1   Rheumazentrum Ruhrgebiet Herne, Herne
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ZUSAMMENFASSUNG

Die virusassoziierte Arthritis macht etwa 1 % aller akuten Arthritiden aus. Obwohl eine Vielzahl der Viren eine Arthritis verursachen können, hat sich das Spektrum der am häufigsten vorkommenden virusassoziierten Arthritiden im Zeitverlauf geändert. Während eine Röteln-assoziierte Arthritis heutzutage und dank Impfmaßnahmen deutlich seltener geworden ist, hat eine Chikungunya-assoziierte Arthritis an Bedeutung gewonnen. Durch die Ausbreitung dieser Erkrankungen hat in diesem Kontext eine Hepatitis-B- oder -C-induzierte Arthritis eine bedeutsame Relevanz. Die Parvovirus-B19-assoziierte Arthritis ist differenzialdiagnostisch, insbesondere bei begleitenden Hautveränderungen, zu berücksichtigen. In der jetzigen Zeit des Klimawandels und Welttourismus haben die durch Arboviren assoziierten Arthritiden viel an Bedeutung gewonnen. In der Pathophysiologie einer solchen Arthritis hat die direkte virale Invasion der Gelenkstrukturen, die Entwicklung von Immunkomplexen und das Auftreten einer Immundysregulation eine wichtige Rolle. Die Arthritis kann unterschiedliche Muster aufweisen, ist in der Regel selbstlimitierend und hinterlässt keine Gelenkschäden. Sie wird häufig von anderen klinischen Merkmalen, die für die Differenzialdiagnose wichtig sind, begleitet. Die Laboruntersuchungen spielen in der Diagnosestellung eine untergeordnete Rolle und sind nur mit zeitlichen Verlaufsmustern relevant. Die Therapie ist bis auf bestimmte Ausnahmen in den meisten Fällen symptomatisch.

ABSTRACT

Virus-associated arthritis is responsible for approximately 1 % of all acute arthritis. Although a variety of viruses can potentially cause arthritis, the spectrum of virus-associated arthritis most commonly encountered has changed over time. If rubella-associated arthritis is much less common nowadays and thanks to vaccination efforts, chikungunya-associated arthritis has become more important. Due to the spread of these diseases, hepatitis B- or C-induced arthritis has a significant relevance in this context. Parvovirus B19-associated arthritis requires differential diagnostic consideration, especially in the presence of concomitant skin involvement. In the present era of climate change and world tourism, arthritides associated by arboviruses have gained much importance. In the pathophysiology of such arthritis, direct viral invasion of joint structures, development of immune complexes and occurrence of immune dysregulation has an important role. Arthritis can present different patterns, is usually self-limiting and does not leave joint damage. It is often accompanied by other clinical features important for differential diagnosis. Laboratory tests play a minor role in making the diagnosis and are relevant only with temporal patterns of progression. Therapy is symptomatic in most cases with certain exceptions.

Schlüsselwörter

Arthritis - virale Infektionen - Fieber - Antikörper

Keywords

Arthritis - viral infections - fever - antibodies


Publication History

Article published online:
19 April 2022

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