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Reiter's syndrome

Alternative Names
reactive arthritis

Reiter's syndrome is an arthritis, or inflammation of the joints and tendons. It is often accompanied by an inflammation of the eyes, known as conjunctivitis, and certain mucous membranes.

What is going on in the body?
Reiter's syndrome refers to a disease in which a person develops acute arthritis in response to an infection. The affected joints involved in the arthritis do not contain infection. The immune system causes inflammation of the joints in response to infection. Reiter's syndrome may be seen following many different infections, including: In a susceptible person, the immune system is activated. For unknown reasons, this causes inflammation of certain joints. This is known as a reactive arthritis or Reiter's syndrome.

What are the signs and symptoms of the disease?
Typically a number of symptoms begin 7 to 14 days after the initial infection:
  • The first symptom is often inflammation of the urethra, which is the channel that carries urine from the bladder to the outside of the body.
  • There may be a discharge from the penis or vagina. The person may experience pain or burning when urinating.
  • The conjunctiva, or membrane that lines the eyelid and covers the eyeball, can become red and inflamed. This causes itching or burning and excessive tearing.
  • Several joints are usually affected at once. The toes, legs, hips, and back are generally involved. There is inflammation, redness, and pain in the affected joints.
  • Small, painless sores develop in the mouth, on the tongue, and on the end of the penis.
  • Occasionally, a distinctive rash of hard, thickened spots may develop on the skin on the palms and soles of the feet. Yellow deposits may develop under the fingernails and toenails.
What are the causes and risks of the disease?
For unknown reasons, certain people appear to have a genetic susceptibility to Reiter's syndrome. Some bacteria and viruses have a tendency to trigger Reiter's syndrome. These include:
  • shigella
  • salmonella
  • campylobacter
  • chlamydia
  • HIV
The symptoms of arthritis only occur in response to an infection at other sites of the body.

What can be done to prevent the disease?
Because some cases of Reiter's syndrome are caused by sexually transmitted diseases, practicing safer sex can eliminate some cases of Reiter's syndrome.

How is the disease diagnosed?
Reiter's syndrome is suspected when someone develops arthritis and has secondary signs of infection. The infectious agent may be cultured from the throat, intestinal tract, or genitourinary tract. Blood tests can help confirm the diagnosis. In some cases, fluid from the joints is removed by a needle. The fluid is then examined, which helps confirm an arthritic condition.

What are the long-term effects of the disease?
Although most people have complete resolution of their symptoms, some may be left with ongoing joint pain or inflammation. They also may develop chronic eye irritation known as uveitis, which may require further therapy.

What are the risks to others?
The original infection, which triggers Reiter's syndrome, can be spread to others. However, not all people will develop Reiter's syndrome as a result of the infection, because this requires a genetically vulnerable host.

What are the treatments for the disease?
Antibiotics are used to treat the infection. Often non-steroidal anti-inflammatory drugs (NSAIDs) are used to help control the pain and inflammation. Steroids may be given to control the swelling too.

What are the side effects of the treatments?
The side effects are related to the individual medications. Antibiotics may cause stomach upset, diarrhoea, and in some cases an allergic reaction. NSAIDs can cause stomach upset and allergic reactions. Steroids may cause weight gain, high blood pressure, acne, easy bruising, bone loss, increased blood sugar, and an increased risk of infection, cataracts, glaucoma, and muscle weakness.

What happens after treatment for the disease?
Arthritis symptoms may continue for up to 4 months. Most people recover in 2-16 weeks, but some have recurrent flare-ups and remissions.

How is the disease monitored?
Repeated physical examinations and blood tests help monitor the disease. Any new or worsening symptoms should be reported to the doctor.

Author: Bill Harrison, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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