Understanding and Managing Reiter’s Syndrome: A Comprehensive Guide

Understanding and Managing Reiter's Syndrome: A Comprehensive Guide

Morbus Reiter begins with a bacterial infection and its usual symptoms. As soon as these have subsided, the joints suddenly hurt, the eyes itch, and there is a burning sensation when urinating. Reiter’s syndrome, also known as Reiter’s disease or urethro-oculo-synovial syndrome, prolongs the symptoms of an infection and can cause problems for those affected for a long time.

Morbus Reiter – what is it?

Reiter’s disease is characterized by inflammation in various body parts, particularly in the joints, urethra and conjunctiva of the eye. It occurs as a secondary disease in up to four per cent of patients with intestinal or urethral infections (mainly through chlamydia, rarely other pathogens such as mycoplasma and salmonella ). It is to be understood as a reaction to the body’s defences.

Remaining the pathogens as foreign substances triggers an inflammatory reaction of the immune system, which then targets the body’s cells. However, the exact course of events is still unclear. Reiter’s disease is counted among the autoimmune diseases and regarded as a particular form of ” reactive arthritis “, i.e. an inflammation of the joints as a result of an infection distant from the joint.


Who is particularly at risk?

People with a hereditary predisposition (the congenital tissue characteristic HLA-B27), which is also found, for example, in Bechterew’s disease, are particularly at risk.

About three to five per 100,000 inhabitants are affected in Western countries, more men than women, mainly between the ages of 20 and 40.

Reiter’s disease: a symptom of joint inflammation

Symptoms begin within a few days to weeks after a feverish gastrointestinal or urinary tract infection. Asymmetric inflammation of several joints (arthritis), accompanied by fever, is typical and almost always present. Knee and ankle joints and the sacroiliac joint between the ilium and sacrum are particularly affected.

The symptoms range from mild to severe paroxysmal Pain and can also spread to finger or toe joints and the attachments of eyes and muscles. It is not uncommon for those affected to complain of nocturnal back pain.


Other symptoms of Reiter’s disease

In addition to inflammation in the joint, conjunctivitis (conjunctivitis) with photophobia and burning of the eyes, as well as inflammation of the urethra (urethritis) with burning, can cause Pain when urinating and possibly discharge from the urethra.

In addition to this typical combination, the “Reiter triad”, many other symptoms can occur. In principle, the inflammatory reaction can affect all other organs. Not uncommon are:

  • Psoriasis-like skin inflammations (Reiter’s dermatoses)
  • Painless reddish nodules in the glans area
  • Inflammation of the nails

The soles of the hands and feet can thicken due to excessive callus formation, and small ulcers can appear on the oral mucosa. Internal organs such as the heart muscle, the nervous system or the intestines are rarely affected.

Diagnosis of Reiter’s disease

The medical history and the symptoms with the typical symptoms often lead to the correct diagnosis. The pathogens can be detected using blood, stool or urine tests.

The vast majority of those affected also have the hereditary antigen HLA-B27 in their blood. X-rays and ultrasound examinations can provide information about the extent of the joint inflammation.

If organ involvement is suspected, computer tomography is also used.

Therapy of Reiter’s disease

If the original infection is still active, it is treated with antibiotics. In the case of urinary tract infections or sexually transmitted diseases, the partner must be examined and, if necessary, treated.

In addition, treatment depends on the symptoms. Physical applications such as cold therapy and anti-inflammatory painkillers such as ibuprofen or Diclofenac help against joint inflammation.

If several joints are affected, if the inflammation in the eye spreads to the iris or if organs are involved, Cortisone is also used. a>


Course and prognosis of Reiter’s disease

In about a third of patients, acute Reiter’s syndrome progresses into a chronic form. The sooner the disease is recognized and treated, the better the prognosis. Therefore, A doctor should be consulted early, especially if joint problems arise following an infection of the gastrointestinal or urinary tract.

The disease healed after six months for around half of those affected, and for some, even after a year. The more joints are affected, the longer it can last – an average of three years, in rare cases, up to 15 years.

Complications in the chronic course of Reiter’s disease

Complications of a chronic course can include increasing destruction of the affected joints and even complete loss of function.

If the eye inflammation spreads to the iris and the suspensory apparatus of the lens (iridocyclitis), visual disturbances or glaucoma may result.

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