Possible Post-streptococcal reactive arthritis

Dear Ask The Doctor: When I was a child I suffered from Chronic Strep Throat for several years. At 12 years old, after an infection, I started having severe pain in every single joint in my body....and I mean EVERY joint. My doctor tested me for Encephalitis, Lime Disease, Juvenile Arthritis and Arthritis after Strep. I ended up being diagnosed with Arthritis after strep and was kept out of school for 2 weeks because I was told not to climb ANY stairs and had to sleep downstairs because my bedroom was on the second floor of our home. It took almost a month but I finally got over it. I was wondering why strep throat would cause arthritis and if having gotten Arthritis after Strep could possibly cause any problems with arthritis later in life.

Dear Tara: Post-streptococcal reactive arthritis has been proposed as a clinical entity different from acute rheumatic fever (ARF) and from other forms of reactive arthritis (those associated with the HLA B27 positive gene). In a high percentage of the cases is associated with Group A streptococcal infection although a significant number were groups B, C, or pyogenes.  Joint involvement is typically non-migratory and affects the large joints, particularly those of the lower limb. Other complications include: heart problems (in children) and kidney problems (less common). Post-streptococcal arthritis typically occurs two to three weeks after the infection has cleared. It is likely this inflammatory disease only occurs in those with a genetic risk factor. Although a sore throat is common, only a small percentage is due to streptococcus and less than 2% of patients infected by Streptococcus go on to have reactive arthritis or other autoimmunity.  Like other forms of reactive arthritis, the usual treatment is with either prolonged regular ibuprofen or steroids. The antibiotic penicillin may be given to ensure eradication of the bacteria.  In some patients penicillin is continued to prevent recurrences of reactive arthritis or if there is suspicion of rheumatic fever. The disease is usually self-limiting with no long term damage if treated correctly.