Reiter’s syndrome – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 12, 2021 4:09 am Published by

Reiter’s syndrome (reactive arthritis) is a sexually acquired reactive autoimmune disease.

Sn. & Sx.:

  • Constitutional symptoms (fatigue, malaise)
  • Flu-like symptoms (fever, myalgia, arthralgia)
  • Skin rash
  • Uveitis
  • Iritis, conjunctivitis
  • Urethritis, prostatitis
  • Peripheral and axial arthritis
  • Low back pain radiating to butt/thighs (worse with bed rest)

“Can’t see, Can’t pee, Can’t dance with me”

dDx.:

  • Ankylosing spondylitis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Septic arthritis
  • Disseminated gonococcal disease
  • Systemic lupus erythematous
  • Cystitis

Sequelae:

  • Ankylosing spondylitis
  • Secondary osteoarthritis
  • Cataracts
  • Blindness

Work up:

  • Inflammatory markers (elevated ESR, CRP)
  • Serology (HLA B27)
  • Urinary analysis (leukocytosis)
  • Imaging (X-ray showing asymmetric vertebral involvement)

Tx.:

  • Antibiotics
  • Anti-inflammatories (corticosteroids)
  • Disease modifying anti-rheumatic drugs (methotrexate, sulfasalazine)

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This post was written by Omar Rifai