Reiter Arthritis

A history of urethritis and prostatitis in men or of cervicitis and cystitis in women is common in patients with ReA. The disease has been called HLA-B27 associated ReA and includes classical Reiter s disease with arthritis, urethritis and conjunctivitis. Presenting symptoms and signs are mostly asymmetrical axial and/or peripheral arthritis. Determining the B27 status of an individual patient with ReA is irrelevant to therapy. Diagnosis usually can be made by clinical examination and history. 

The sahcylates are useful in the treatment of minor musculoskeletal disorders such as bursitis, synovitis, tendinitis, myositis, and myalgia. They may also be used to relieve fever and headache. They can be used in the treatment of inflammatory disease, such as acute rheumatic fever, rheumatoid arthritis, osteoarthritis, and certain rheumatoid variants, such as ankylosing spondylitis, Reiter s syndrome, and psoriatic arthritis. However, other NS AIDS are usually favored for the treatment of these chronic conditions because of their lower incidence of GI side effects. Aspirin is used in the treatment and prophylaxis of myocardial infarction and ischemic stroke. 

Psoriasis can occur in association with chronic juvenile arthritis as well as Reiter s syndrome. Some investigators have demonstrated a significant increase in prevalence in patients with human immunodeficiency virus infection.The pathogenesis of this relationship is imclear, but an immune recognition event may occm related to the HLA-B27 antigen. A large, retrospective, population-based study found that psoriatic arthritis is mild, imcom-mon, and not associated with a significant increase in mortality. 

Most disorders in this group do not present with significant ocular involvement. However, SEE, periarteritis nodosa, Reiter s syndrome (reactive arthritis), juvenile RA, and, in some instances, RA can be clinically identified by their ophthalmic presentation at an early stage in the disease. There is evidence that early treatment can reduce morbidity and have a positive impact on the course of these disorders. 

Those patients who develop psoriatic arthritis with spinal involvement are most likely to test positive for the HLA-B27 genetic marker also implicated in alky losing spondylitis and Reiter s syndrome. 

The most common types of arthritis in the UK are osteoarthritis (UK prevalence 23%) and rheumatoid arthritis (1%). The less common t3 es of inflammatory arthritis include juvenile idiopathic arthritis spondylarthritis (ankylosing spondylitis, Reiter s syndrome, psoriatic arthritis, arthritis associated with inflammatory bowel disecise) and reactive arthritis associated with infection. Joint pains (arthralgia) are common in many other diseases, for example the connective tissue diseases (systemic lupus erythematosus, scleroderma), endocrine conditions (hypo-and h5 erthyroidism) and malignancies, but in these, joint inflammation and damage do not usually occur. 

Crohn s syndrome Reiter s Disease (Reactive arthritis) 1 1 1 1 after enteric infection Increased in young white men but increasing in... 

Reiter s Disease (reactive arthritis) Vertebral joints >15% develop alkylosing spondylitis or severe arthritis with neurologic sequelae... 

Reiter s Syndrome is an inflammatory arthritis that produces pain, swelling, redness and heat in the joints. It is one of a family of arthritic disorders, called spondylarthropathies, affecting the vertebral joints The symptoms of Reiter s disease include fever, weight loss, skin rash, inflammation, ulcerations, and pain. Unlike many autoimmune disorders, Reiter s syndrome usually affects young white men between the ages of 20 and 40. 

Other rare complications have been seldom reported, namely cryoglobulinemia with evidence of disseminated BCG infection (16), ruptured mycotic aneurysm of the abdominal aorta (17), bladder wall calcification (18), rhabdomyolysis (19), iritis or conjunctivitis with arthritis or Reiter s syndrome (20,21), and severe acute renal insufficiency due to granulomatous interstitial nephritis, which can occur even in the absence of other systemic complications (22). 

Arthritis and arthralgia are well-known adverse effects of intravesical BCG instillation as part of therapy of bladder cancer (SED-13, 925). The etiology and the different clinical pictures of BCG immunotherapy have been discussed (51). Considering that mycobacteria are potent stimulators of the immune system and especially of T cells, it is not surprising to observe T cell-mediated aseptic arthritis after BCG therapy. The authors suggested that the site of immune stimulation is critical, since intradermal injection produces a clinical presentation similar to reactive arthritis, and intravesical therapy causes a clinical picture identical to Reiter s syndrome. 

Chronic fatigue syndrome Multiple sclerosis Reiter s syndrome Rheumatoid arthritis... 

If left untreated, bacfllary dysentery usually lasts about 1 week (range 1-30 days). Complications are unusual but may include severe dehydration, generalized seizures, septicemia, toxic megacolon, perforated colon, arthritis, protein-losing enteropathy, and HUS. Mortality is rare, but it may be more likely with S. dysenteriae type I. Fess than 3% of persons who are infected with S. flexneri will later develop Reiter s syndrome, characterized by pains in the joints, irritation of the eyes, and painful urination. This can lead to chronic arthritis. ... 

In the following year, Kuzell, Schaffarzick, Mankle and Gardner [242] published their study of copper therapy in a variety of rheumatoid and degenerative diseases. The purpose of their clinical study was to evaluate cuproxoline and allocupreide in patients who had RA, RA with psoriasis, Reiter s syndrome, ankylosing spondylitis, and chronic gouty arthritis, as shown in Table 6.11. 

It is a pyrazole derivative which has antipyretic, analgesic and anti-inflammatory actions, because of its toxicity it is not used as a general antipyretic or analgesic. It is, an usual practice, reserved for use in the treatment rheumatic disorders, such as osteoarthrosis, rheumatoid arthritis, ankylosing spondylitis, arthritis, acute superficial thrombophlebitis, painful shoulder and Reiter s disease, where less toxic drugs have failed. 

Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal. About 3% of persons who are infected with one type of Shigella, Shigella flexneri, will later develop pains in their joints, irritation of the eyes, and painful urination. This is called Reiter s syndrome. It can last for months or years, and can lead to chronic arthritis which is difficult to treat. Reiter s syndrome is caused by a reaction to Shigella infection that happens only in people who are genetically predisposed to it. 

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