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Sexually-Associated Reactive Arthritis (SARA)

Sexually-Associated Reactive Arthritis (SARA) is a topic covered in the Johns Hopkins ABX Guide.

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  • Mechanism of SARA pathogenesis not completely known. Appears to be due to an immune response to urogenital organisms or to persistence of organism in synovial tissue.
    • Chlamydia trachomatis (CT): organism most strongly linked to SARA.
      • Identified in 35-70% of cases using non-nucleic acid amplification techniques.
      • When CT is the underlying cause, an aberrant form with repressed synthesis of the major outer membrane protein and active production of heat shock protein appears, contributing to the inflammatory response.
    • Neisseria gonorrheae: linked to up to 16% of cases, distinct from gonococcal arthritis.
    • Ureaplasma urealyticum and Mycoplasma genitalium: linked to a few cases, a minor cause of SARA.
  • Causal role for other genital tract pathogens is unclear.

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Last updated: November 2, 2015


Hynes, Noreen A, and Valeria Fabre. "Sexually-Associated Reactive Arthritis (SARA)." Johns Hopkins ABX Guide, The Johns Hopkins University, 2015. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540500/all/Sexually_Associated_Reactive_Arthritis__SARA_.
Hynes NA, Fabre V. Sexually-Associated Reactive Arthritis (SARA). Johns Hopkins ABX Guide. The Johns Hopkins University; 2015. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540500/all/Sexually_Associated_Reactive_Arthritis__SARA_. Accessed July 24, 2019.
Hynes, N. A., & Fabre, V. (2015). Sexually-Associated Reactive Arthritis (SARA). In Johns Hopkins ABX Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540500/all/Sexually_Associated_Reactive_Arthritis__SARA_
Hynes NA, Fabre V. Sexually-Associated Reactive Arthritis (SARA) [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2015. [cited 2019 July 24]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540500/all/Sexually_Associated_Reactive_Arthritis__SARA_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sexually-Associated Reactive Arthritis (SARA) ID - 540500 A1 - Hynes,Noreen,M.D., M.P.H., D.T.M.&H. AU - Fabre,Valeria,M.D. Y1 - 2015/11/02/ BT - Johns Hopkins ABX Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540500/all/Sexually_Associated_Reactive_Arthritis__SARA_ PB - The Johns Hopkins University DB - Johns Hopkins Guide DP - Unbound Medicine ER -