Reiter

Reiter gdanski 2.1

Michałowski Reiter

Dresden-Zwinger-Armoury-Armor.13

Reitschwert by Wendelin Boeheim

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Reiter's syndrome, also known as reactive arthritis, is a form of arthritis that occurs as a reaction to an infection elsewhere in the body. The condition is characterized by three main features: inflammation of the joints (arthritis), inflammation of the eyes (conjunctivitis or uveitis), and urethritis in men or cervicitis in women. It is considered a type of spondyloarthritis, a group of rheumatic diseases that specifically affect the spine and other joints.

Causes and Pathogenesis

Reiter's syndrome is typically triggered by an infection, most commonly in the genitourinary tract or the gastrointestinal tract. The most common infectious agents associated with Reiter's syndrome include Chlamydia trachomatis, which is transmitted sexually, and bacteria such as Salmonella, Shigella, Yersinia, and Campylobacter, which are acquired through contaminated food or water. The exact mechanism by which these infections lead to Reiter's syndrome is not fully understood, but it is believed to involve an abnormal immune response in genetically susceptible individuals.

Symptoms

The classic triad of symptoms in Reiter's syndrome includes arthritis, conjunctivitis, and urethritis. However, not all patients will have all three symptoms. Other possible symptoms include skin rashes, particularly keratoderma blennorrhagica (a rash on the soles of the feet or palms of the hands), and mucocutaneous lesions. Patients may also experience fever, weight loss, and fatigue.

Diagnosis

Diagnosis of Reiter's syndrome is primarily based on the clinical presentation and the history of a preceding infection. Laboratory tests may show elevated levels of inflammation and the presence of HLA-B27, a genetic marker associated with a higher risk of developing spondyloarthritis. Microbiological tests may identify the triggering infection. Imaging tests, such as X-rays or MRI, can reveal signs of arthritis and other changes in the joints.

Treatment

Treatment of Reiter's syndrome focuses on relieving symptoms and treating any underlying infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and inflammation. In cases where NSAIDs are not effective, corticosteroids may be prescribed. Antibiotics are used to treat the triggering infection. In some cases, disease-modifying antirheumatic drugs (DMARDs) or biologic agents may be necessary to control the arthritis.

Prognosis

The prognosis for individuals with Reiter's syndrome varies. Some people may experience a single episode that resolves within a few months, while others may have recurrent episodes or develop chronic arthritis. Early diagnosis and treatment can improve the outcome by helping to control symptoms and prevent complications.

Epidemiology

Reiter's syndrome is more common in men than in women, particularly affecting men between the ages of 20 and 40. The condition is also more prevalent among individuals with the HLA-B27 genotype.

History

The syndrome was named after Hans Reiter, a German physician who described the condition in 1916. However, the use of Reiter's name has become controversial due to his involvement in Nazi war crimes. As a result, the term "reactive arthritis" is increasingly used to refer to the condition.

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