Reactive arthritis

General or Other | Rheumatology | Reactive arthritis (Disease)


Description

Reactive arthritis (Reiters syndrome or Reiters arthritis), is classified as an autoimmune condition that develops in response to an infection in another part of the body (cross-reactivity).

Reiters syndrome has symptoms similar to various other conditions collectively known as arthritis. By the time the patient presents with symptoms, oftentimes the trigger infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

Triad of symptoms: an inflammatory arthritis of large joints including commonly the knee and the back (due to involvement of the sacroiliac joint), inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Patients can also present with mucocutaneous lesions, as well as psoriasis-like skin lesions such as circinate balanitis, and keratoderma blennorrhagica. Enthesitis can involve the Achilles tendon resulting in heel pain.

Causes and Risk factors

Reactive arthritis develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease.

Not all affected persons have all the manifestations, and the formal definition of the disease is the occurrence of otherwise unexplained non-infectious inflammatory arthritis combined with urethritis in men, or cervicitis in women.

Reactive arthritis most commonly strikes individuals aged 20–40 years of age, is more common in men than in women, and more common in white than in black people. This is owing to the high frequency the of HLA-B27 gene in the white population. Patients with HIV have an increased risk of developing reactive arthritis as well.

Diagnosis and Treatment

The goal of treatment is to relieve symptoms and treat any underlying infection.

Conjunctivitis and skin lesions associated with the syndrome do not require treatment, and will go away on their own. the doctor will prescribe antibiotics if you have an infection. Nonsteroidal anti-inflammatory drugs and pain relievers may be recommended for those with joint pain. If a joint is persistently inflamed, a doctor may inject a strong anti-inflammatory medicine (corticosteroid) into the area.

Physical therapy can help relieve pain, help you move better, and maintain muscle strength. Therapy to suppress the immune system may be considered for individuals with a severe case of the disease, but this treatment is not used in most people because of toxic side effects. ...