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Arthritis und Rheuma 2005; 25(02): 71-76
DOI: 10.1055/s-0037-1618492
Rheuma und Infektion
Schattauer GmbH

Virusassoziierte Arthritiden

Virus-associated arthritis
Klaus Korn
1   Institut für Klinische und Molekulare Virologie der Friedrich-Alexander-Universität Erlangen-Nürnberg (Leiter: Prof. Dr. med. Bernhard Fleckenstein)
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Publication History

Publication Date:
23 December 2017 (online)

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Zusammenfassung

Infektionen mit einer Vielzahl von Viren sind im Zusammenhang mit akuten oder chronischen Arthritiden beschrieben. Gemeinsam ist den virusassoziierten Arthritiden, dass es sich um nicht eitrige Entzündungen handelt. Es kommen sowohl Mono- und Oligoarthritiden vor allem größerer Gelenke als auch Polyarthritiden vor. Als pathogenetischer Mechanismus wird vor allem die Ablagerung von Immunkomplexen angesehen. Ebenfalls beschrieben ist die direkte Infektion von Zellen der Synovia sowie die Bildung von Autoantikörpern. Systematische Untersuchungen zur Epidemiologie der vi-rusassoziierten Arthritis fehlen fast vollständig. Weltweit haben vermutlich Arthritiden im Rahmen von durch Moskitos übertragenen Alphavirus-Infektionen sowie bei Hepatitis B und Hepatitis C die größte Bedeutung. Wo diese Infektionen, wie bei uns in Deutschland, selten sind, steht als weiterer Erreger Parvovirus B19 im Vordergrund. Daneben spielen auch die durch Impfprogramme selten gewordenen Röteln- und Mumps-Infektionen eine gewisse Rolle. Bei Röteln ist zu beachten, dass es auch durch den attenuierten Lebendimpfstoff zu Arthritiden kommen kann. Möglichkeiten der spezifischen antiviralen Therapie und Prophylaxe sind bisher kaum etabliert.

Summary

Acute or chronic arthritis has been described in association with a large number of viral infections. Virus-associated arthritis is generally non-purulent. It can occur as mono- or oligoarthritis mainly of larger joints, but also as polyarthri-tis. Deposition of immune complexes is supposed to be a major pathogenetic mechanism. However, direct infection of cells in the synovia and the formation of autoantibodies have also been described.

Systematic studies on the epidemiology of virus-associated arthritis are lacking. Worldwide, mosquito-borne alphavi-ruses and hepatitis B and C viruses are probably the most common agents of viral arthritis. In areas like Germany, where such infections are rare, parvovirus B19 is another prominent cause of viral arthritis. Furthermore, rubella and mumps infections, although substantially reduced in numbers by vaccination programs, play a certain role. In the case of rubella, it has been shown that also the attenuated vaccine virus is able to induce arthritis. Currently, possibilities for specific antiviral therapy or prophylaxis of viral arthritis are very limited.

Schlüsselwörter

Virusinfektion - reaktive Arthritiden

Keywords

Viral infection - reactive arthritis
 

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