Syndrome of Reuters

The syndrome of Reuters, or reactive arthritis, represents an autoimmune inflammation of joints, urinogenital bodies, a conjunctiva and other mucous membranes. Results from urinogenital or intestinal infection. Most often clamidiosis, colitis or ureaplasmosis is the reason of a syndrome of Reuters. In most cases the disease affects men at the age of 20-40 years, sometimes – women. It practically does not occur at children. Dysfunction of joints, deterioration in sight, erectile frustration, infertility can be a complication of a syndrome of Reuters. Besides, the disease reflects adversely on kidneys, heart, an aorta.

Symptoms of a syndrome of Reuters

At a syndrome of Reuters symptoms begin to be shown in 1-2 weeks after penetration of an infection into an organism and have various localization:

• Urethra. Inflames first of all. At men the urination is followed by painful feelings. There are allocations from an urethra. The inflammation can affect a prostate gland also. At women inflammatory process takes place easier – in the form of scanty allocations from a vagina and discomfort at an urination;
• Conjunctiva. Reddens and inflames. Burning, an itch and dacryagogue is noted;
• Joints. The inflammation and pain of various degree of manifestation appear at the same time in a knee joint, in toes and a hillock of a calcaneus. In hard cases backbone joints inflame;
• Mucous. In language, in a mouth and on a balanus there are small painless ulcers;
• Skin. Under nails skin color can get a yellowish shade, and on palms and soles characteristic dense spots are observed.

In 3-4 months these symptoms of a syndrome of Reuters disappear, but arthritis can recur. Sometimes deformation of joints and a backbone develops. In rare instances there comes disability.

Diagnosis of a syndrome of Reuters

Diagnosis of a syndrome of Reuters on the basis of complaints of patients, the anamnesis and identification of a combination of conjunctivitis, arthritis, a coloenteritis and urethritis is carried out. Laboratory and tool data confirm the diagnosis.

Laboratory researches include the general and biochemical analysis of blood, the general analysis of urine. Establish existence or absence of clamidiosis by method of polymerase chain reaction. Conduct a cytologic research of a mucous urethra, the cervical channel and a conjunctiva, and also juice of a prostate and sperm. Besides, study synovial fluid and reveal HLA B27 carriage.

At a radiology of joints reveal asymmetric narrowing of joint cracks and asymmetrical para-articular osteoporosis. If radiological diagnosis of a syndrome of Reuters is carried out at long disease, then erosive and destructive changes – a calcaneal spur, the isolated spurs on vertebrae, multiple erosion of joints are probable. Approximately in half of cases the unilateral sacroileitis is found.

Serve as diagnostic criteria:

• Chronological communication between an intestinal or urinogenital infection and emergence of symptoms of arthritis, conjunctivitis and damages of mucous membranes and skin;
• Age and sex of patients;
• Acute arthritis of joints of the lower extremities with a calcaneal bursitis and an entezopatiya;
• The inflammation of an urinogenital path and chlamydia found in a buccal swab of the channel of a neck of uterus or an urethra;
• The asymmetric seronegative oligoarthritis, tsertsivit or a nonspecific urethritis.

Treatment of a syndrome of Reuters

At a syndrome of Reuters treatment is not always successful and can be quite long. During the acute period of a disease of the patient appoint antibiotics, such as tetracycline or erythromycin. The course proceeds 3-4 weeks at an average dosage. Arthritis treat anti-inflammatory nonsteroid drugs. If the effect is absent, then enter glucocorticoids into the inflamed joint. At a chronic current prolonged use of quinolinic drugs is shown, but sometimes the inflammation of joints and a backbone recurs. The strong inflammation of a conjunctiva is removed eye drops or ointments with corticosteroids. For prevention of a syndrome of Reuters it is necessary to observe hygiene of sex life, to warn intestinal infections and in time to treat an urethritis and a coloenteritis.