Reiter's syndrome or reactive arthritis, is an autoimmune inflammation of the joints, genito-urinary organs, conjunctiva and other mucous membranes. It arises from the urogenital or intestinal infection. The most common cause Reiter's syndrome is chlamydia, colitis or ureaplasmosis. In most cases, the disease affects men aged 20-40 years, sometimes - women. In children, it almost does not occur. Complication Reiter's syndrome may be dysfunction of the joints, blurred vision, erectile disorders, infertility. In addition, the disease adversely affects the kidney, heart, aorta.
Symptoms of Reiter's syndrome
When Reiter syndrome symptoms begin to appear 1-2 weeks after infection penetration into the body and have a different location:
- Urethra. Inflamed in the first place. Men urination and painful sensations. There are discharge from the urethra. The inflammation may also affect the prostate gland. In women, the inflammatory process is easier - a scant vaginal discharge and discomfort when urinating;
- Conjunctiva. Red and inflamed. There burning, itching and watery eyes;
- Joints. Inflammation and pain of varying degrees of severity appear simultaneously in the knee joint in the toe and the calcaneal tuberosity. In severe cases, the inflamed joints of the spine;
- Mucous. On the tongue, mouth and head of the penis there are small painless ulcer;
- Leather. Under the nail color may acquire a yellowish tint, and on the palms and soles of the observed characteristic tight spots.
After 3-4 months, these symptoms disappear Reiter's syndrome, arthritis, but may recur. Sometimes develops deformation of joints and spine. In rare cases, the disability occurs.
Diagnosis of Reiter's syndrome
Reiter's syndrome to diagnose on the basis of patients' complaints, medical history and identify combinations of conjunctivitis, arthritis, enterocolitis, and urethritis. Laboratory and instrumental data confirm the diagnosis.
Laboratory studies include general and biochemical blood tests, urinalysis. Establish the presence or absence of chlamydia by polymerase chain reaction. Spend cytology mucous urethra, cervix and conjunctiva, and the juice of the prostate and sperm. In addition, the study synovial fluid and carrier detect HLA B27.
When joints radiology reveal asymmetric narrowing of joint cracks and unbalanced para-articular osteoporosis. If the radiological diagnosis of Reiter's syndrome is carried out with long-term course of the disease, the probability of erosive-destructive changes - heel spurs, spurs on isolated vertebrae, multiple erosion of joints. Approximately half of the cases detected unilateral sacroiliitis.
Diagnostic criteria are:
- The chronological relationship between intestinal or genitourinary infection and the appearance of symptoms of arthritis, conjunctivitis, and lesions of the mucous membranes and skin;
- Age and sex of patients;
- Acute arthritis of the joints of the lower limbs with a heel bursitis and enthesopathies;
- Inflammation of the urinary tract and chlamydiae found in epithelial scrapings endocervical or urethral;
- Asymmetrical seronegative oligoarthritis, tsertsivit or non-specific urethritis.
Reiter's syndrome Treatment
When Reiter's syndrome treatment is not always successful and can be quite long. During the acute phase of the disease the patient is prescribed antibiotics, such as tetracycline or erythromycin. The course lasts 3-4 weeks, with an average dosage. Arthritis treated with non-steroidal anti-inflammatory agents. If there is no effect, the inflamed joint is administered glucocorticoids. In chronic course shows prolonged use of quinoline drugs, but sometimes inflammation of the joints and spine recurs. Severe inflammation of the conjunctiva relieve eye drops or ointments with corticosteroids. For the prevention of Reiter's syndrome should be observed sexual health, prevent intestinal infections, and in time to treat urethritis and enterocolitis.