Reiter syndrome (Reiter's disease)

Reiter's disease begins with a bacterial infection and its usual symptoms. As soon as they have subsided, the joints suddenly start to ache, the eyes itch, and when they urinate it burns. Reiter's syndrome, also called rider's disease or urethro-oculo-synovial syndrome, prolongs the symptoms of an infection and can cause long-term problems.

Reiter's disease - what is it?

Reiter's disease is characterized by inflammation in various parts of the body, especially the joints, urethra and conjunctiva of the eye. It occurs as a consequence of disease in about 3% of patients with intestinal or urethral infections (especially by chlamydia, rarely other pathogens such as mycoplasma and salmonella) on and is to be understood as a response of the body's defense.

Presumably remnants of the pathogens as foreign substances trigger an inflammatory reaction of the immune system, which then targets the body's own cells. The exact course is still unclear. Reiter's disease is thus considered to be an autoimmune disease and is regarded as a special form of "reactive arthritis", ie joint inflammation as a result of a joint-distant infection.

Particularly at risk are people with a hereditary predisposition (the innate tissue feature HLA-B27), the z. B. also in the Bechterew disease finds. Affected in Western countries are about 3-4 per 100, 000 inhabitants; about 20 times more men than women, usually between the age of 20 and 40 years.

Symptoms of Reiter's Disease

Symptoms begin within a few days to weeks after a febrile gastrointestinal or urinary tract infection. Typically and almost always present are asymmetric inflammation of several joints (arthritis), accompanied by fever. Above all, knee and ankle joints and the sacroiliac joint between the intestinal and sacrum are affected. The symptoms range from mild to severe, episodic pain and can also spread to finger or toe joints and the approaches of vision and muscles. Not infrequently the patients complain of nocturnal low back pain.

In addition, it comes to conjunctivitis (conjunctivitis) with photophobia and burning of the eyes and the urethra (urethritis) with burning pain when urinating and possibly discharge from the urethra. In addition to this typical combination, the "Reiter-Triassic", many other symptoms can also occur. In principle, the inflammatory response can affect all other organs. Not infrequently psoriasis-like dermatitis (rider dermatoses), painless reddish nodules in the area of ​​the glans and inflammation of the nails.

The soles of the feet and feet may thicken due to excessive corneal formation, small ulcers may occur on the oral mucosa. Rarely, internal organs such as the heart muscle, the nervous system or the intestine are affected.

Diagnosis of Reiter's disease

Often the medical history and the symptoms with the typical symptoms lead to the correct diagnosis. With the help of blood, stool or urine tests, the pathogens can be detected. About 80% of those affected also have the hereditary antigen HLA-B27 in their blood. X-ray and ultrasound can provide information about the extent of joint inflammation. If organ involvement is suspected, computed tomography is also used.

Therapy of Reiter's Disease

If the original infection is still active, it will be treated with antibiotics; in urinary tract infections or sexually transmitted diseases, the partner must be examined and possibly treated. In addition, the treatment depends on the symptoms. Physical applications such as cryotherapy and anti-inflammatory analgesics (eg, ibuprofen, diclofenac) help against arthritis. If several joints are affected, the inflammation in the eye spreads to the iris or organs are involved, cortisone is also used.

Course and prognosis of Reiter's disease

In about one third of the patients the acute Reiter syndrome changes into a chronic form. The sooner the disease is recognized and treated, the better the prognosis. Therefore, a doctor should be consulted at an early stage, especially in newly occurring joint discomfort after an infection of the gastrointestinal tract or urinary tract.

In about 50% of those affected the disease heals after half a year, at 70-80% after one year. The more joints are affected, the longer it can take - on average 3 years, in rare cases up to 15 years.

As complications of a chronic course, it can lead to increased destruction of the affected joints to complete loss of function. If the inflammation in the eyes spreads to the iris and the suspension apparatus of the lens (iridocyclitis), visual disturbances or a cataract may result.

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