Reiter's syndrome and reactive arthritis
What is it?
This is an inflammation that causes pain, swelling, redness of the joints and increase in the temperature of the skin surfaces above the joints. Reactive arthritis belongs to the group of seronegative spondyloarthropathies (a family of joint diseases), which most often affect the spine, sactoiliac joints and the points of attachment of tendons to the bone (enteritis). However, it can affect many other parts of the body, including the joints of lower extremities.
Inflammation begins as a result of an incorrect reaction caused by an extra-articular infection; more often, urogenital (urethritis, cystitis, prostatitis, etc.) or intestinal (enteritis with diarrhea, etc.).
The eyes may also be affected (the triad of arthritis, urethritis and uveitis are characteristic of Reiter’s syndrome), as well as the oral mucosa, on which characteristic ulcers form.
The disease is named after Hans Reuter, a German military doctor who first described the disease in 1916 during the First World War. Reiter described a case of arthritis, urethritis and conjunctivitis in a sick officer who had suffered from dysentery.
Causes and risk factors
The cause is unknown. Often, rheumatoid arthritis is familial in nature, which proves a genetic predisposition to joint damage. About 74% of patients share a common genetic marker - the HLA-B27 molecule.
The disease is rare and most often affects male patients (the ratio of men to women is about 25 to 1). However, in women, the diagnosis may be complicated due to the difficulty of recognizing cervicitis.
The first symptoms are more common between the ages of 20 and 40. However, cases of reactive arthritis (usually post-enteritis) have also been reported in children and people over the age of eighty.
Which are the symptoms?
The most frequent manifestations:
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arthritis;
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fever;
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weight loss;
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skin rashes (similar to psoriasis);
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malaise;
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fatigue;
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malaise during urination (pain and discomfort during urination, urethral discharge)
How is it diagnosed?
Suggested exams
How is it treated?
Treatment is carried out with non-steroidal anti-inflammatory drugs.
Therapy is based on taking sulfasalazine, although it may have limited benefits for spinal and sacroiliac joint damage.
In chronic and more severe forms, biological drugs (TNFα inhibitors) can be used.
The course of the disease is often unpredictable. Periods of exacerbation are often asymptomatic. The disease often becomes chronic with a progressive clinical course.
Where do we treat it?
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