Reiter’s Syndrome

Overview

Reiter’s Syndrome refers to a group of disorders which include conjuntivitis, painful joints, and urinary tract infection. Other disorders included are ankylosing spondylitis, psoriatic arthritis, and inflammatory bowel syndrome arthritis. It is also known as reactive arthritis. This is because arthritis results from the infection at another part of the body. Another name for Reiter’s syndrome is seronegative spondyloarthropathy. This is because it causes inflammations at the joints.

Symptoms

* Early symptoms of an initial infection Flu-like symptoms Fever Vomiting Gastrointestinal symptoms Diarrhea * Arthritis Joint pain Joint swelling Joint redness Joint warmth Joint stiffness Knee arthritis Ankle arthritis Feet arthritis Toe arthritis Enthesopathy (inflammation of tendon-bone attachments) Heel pain Shortening and thickening of fingers and toes Heel spurs Spondylitis (vertebrae inflammation) Sacroiliitis Spine arthritis Back pain Tendonitis Ligament inflammation * Eye symptoms Conjunctivitis - about 50-75% of cases Uveitis Iris inflammation Cornea inflammation Eye redness Eye pain Eye irritation Blurred vision Watery eyes * Urinary tract symptoms (male) Urethritis Non-specific urethritis Increased urination Urinary burning Urethritis Penis dischage Pus in urine Prostatitis Fever Chills * Urinary tract symptoms (female) Cervicitis Urethritis Urinary burning Salpingitis (inflammation of the fallopian tubes) Vulvovaginitis Vaginitis * Heart problems - about 10% of long-term cases Aortic regurgitation Pericarditis Heart-valve problems * Other symptoms Mouth ulcers Skin rashes Penis tip ulcers (balanitis circinata) - small and painless sores. Keratoderma blennorrhagica - small nodule rashes on soles of feet (sometimes palms of hands) Thickening palms Thickening soles of feet Thickening of skin around the nails Dysentery * Inflammation of urethra * Balanitis circinata * Conjunctivitis * Arthritis * Joint pain * Mild fever * Pale skin * Warm joints * Joint swelling * Blood in urine * Red joints * Tendinitis * Plantar fasciitis * Pain in bottom of heel * Swollen toes * Ankylosing spondylitis * Inflammation of uvea of the eye * Inflammation of iris of eye * Sensitivity to light * Lesions on head of penis * Skin lesions on palms * Skin lesions on soles * Skin lesions in urethra * Skin lesions in mouth * Skin lesions in bladder * Erosion of lesions * Red lesions * Scaly lesions on hands * Scaly lesions on arms * Scaly lesions on trunks * Eroded lesions on hands * Eroded lesions on arms * Eroded lesions on trunks * Brittle fingernails * Thick fingernails * Opaque fingernails * Anemia * Increased white blood cell level in blood * Increased white blood cell level in synovial fluid * Increased erythrocyte sedimentation rate * Negative tests for rheumatic factor * Presence of HLA-B27

Causes

What actually causes Reiter’s syndrome is not known. But this is the type of arthritis commonly characterised by inflammation that is swelling joints and pain. It is believed that certain sexually transmitted infections like HIV and Chlamydia, gastro intestinal infections such as shigella, salmonella and diarrhoea can trigger Reactive arthritis. It is more associated with Chlamydia trachomatis. It usually occurs one to three weeks after diarrhoea is caused by food poisoning.

Diagnosis

Doctors may then call for imaging tests like the X-ray of the lower spine or the pelvis during the diagnostic process. Another thing is to remove some fluid from the painful joint for examination. The examination involves finding out whether there is a higher number of white blood cells or not. The patient’s history of infections is also examined after the symptoms are identified. It is also important to find out what exactly causes the inflammation of the joints. This is because there could be other causes such as gout and other infections.

Prognosis

Although Reiter’s syndrome varies in from one patient to another, it can be cured with proper therapy, if it is detected early enough. In severe cases may result in poor vision, joint damage and disability. There could be milder cases where the disease is only a temporary problem. Reiter’s syndrome is very risky in men as compare to women. It is equally risky if the blood test shows a general inflammation, and there is poor response to initial treatment.

Treatment

* Bed rest * Exercise * Strengthening exercises * Range-of-motion exercises * NSAID’s Aspirin Ibuprofen * Corticosteroid joint injections * Topical corticosteroids * Antibiotics - to treat any bacterial infection such as Chlamydia. * Immunosuppressants Sulfasalazine Methotrexate