Causes, symptoms, and treatment of disease Reiter

With this disease such as Reiter's syndrome (or Reiter's syndrome), at the same time develop lesions in the eyes (conjunctivitis), joints (reactive arthritis), genitourinary system (uretroprostatit). The disease affects people who are predisposed to it genetically and have in the body of chlamydial infection.

the Syndrome usually appears at a young age – before 40 years, in rare cases occurs in children. Men are affected more often than females (about 20 times).

There are several names. In recent years, the concept of "reactive arthritis" is replacing the name "Reiter's syndrome". This is due to the personality of the German doctor Hans Reiter, who during the war were experimenting on the prisoners of concentration camp Buchenwald.

What triggers disease emergence?

Genetic predisposition plays a role in the development of Reiter's syndrome. Important and various infections of the urinary tract and digestive system. First symptom of the disease is usually urethritis that occurs after intercourse or in connection with the aggravation of chronic inflammation of the urinary tract infectious nature.

the Most common causes of the disease – chlamydia. It's a parasite living inside the cells. If they start to work antibiotics, chemical drugs, there are adverse to their life conditions, microorganisms take L-shape and is able in such a transformed state to parasitize for a long time inside the cells. And the infection takes a chronic course. Women urigenous arthritis is observed in very rare cases. Basically they are only carriers of the infection.

Chlamydia is not only transmitted through sexual contact. Possible household contamination. They are found in the epithelial cells of the urethra and the conjunctiva. In addition to chlamydia, Reiter's syndrome cause Shigella, Salmonella and Yersinia. To develop the disease and maybe once a patient suffered enterocolitis. Among physicians a widespread opinion that Ureaplasma also causes the syndrome.

Leading symptoms

The Disease begins with problems of the urogenital system (usually a hospital) over a certain period (from several days to one month) after infection through sexual contact or enterocolitis.

urethritis When you experience the following symptoms:

• urination
• burning and itching around the opening of the channel of urination
• small allocation in the form of mucus from the vagina, and urethra.

Urethritis, in this case, has pronounced symptoms as for gonorrhea. 1/3 of men it takes place even without any signs and is determined only by an increased level of leukocytes in the smear taken for analysis from the urethra. After the urethritis problems with the eyes. Apart from conjunctivitis, possibly the onset of iritis, retinitis, keratitis. Ocular lesions can last for long, and often the victim does not give them value.

The Next stage of Reiter's syndrome (about a month and a half later) a lesion of joints. More common in this disease arthritis of the feet. The pain occurs often at night, the vessels of the skin under the joints excessively filled with blood. Is characterized by a gradual involvement in the disease of all joints (bottom-up) within a few days. The syndrome is accompanied by inflammation of the tendons, bursitis in the area of the heels (they have severe pain). Develop “spurs”.

Another symptom is pain in the spine. Half of the patients arthritis symptoms completely disappear. In 30% of cases they are repeated, but 20% of patients the arthritis becomes chronic, there comes an atrophy of adjacent muscles and joints begin to act is limited. In some cases, there comes a flatfoot. Joints of the hand are virtually not affected.

The syndrome affects and some mucous membranes and the skin. Ulcers painful type occur in the mouth and on the head of his penis. On the skin papules appear red shades small size. The symptoms can include cracking skin, peeling on the feet and the palms.

In some cases increased (without pain) lymph nodes. It usually happens in the groin area. Possible affection of cardiac muscle (about 30%), nervous system and kidneys. The elevated temperature is kept for a long period.

What research can help to diagnose it?

Reiter's syndrome is diagnosed based on the following criteria:

• the presence of three components (conjunctivitis, urethritis, arthritis)
• the patient's age to 40 years;
• arthritis of the lower limbs (in particular fingers);
• chlamydia detected in the biomaterial of channel voiding and the cervix.

If chlamydia in these scrapings is not found, the diagnosis of chlamydial arthritis is only in the case when they are detected in blood serum. Conducted the following laboratory studies:

• a common blood test that can reveal significant anemia, slight leukocytosis, elevated erythrocyte sedimentation rate;
• the General analysis of urine and pus formation;
• analysis of prostate secretion
• blood chemistry
• Cytology for the detection of chlamydia (done scrapings from the urethral mucosa, investigated the sperm);
• biopsy of synovial fluid (helps to find acute inflammation)
• the identification of antigens.

In Addition, are appointed by instrumental assessment. For example, radiological pictures of the joints help detect the narrowing of the gaps of the joints, periarticular osteoporosis, calcaneal bone spurs and the ones that are on the body some of the vertebrae. Examines phalanges of all toes of both feet, which are detected erosion in about half of patients. This confirms chlamydial arthritis. Once diagnosed, treatment begins the patient and his sex partner.

modes of treatment

Usually, patients go to the doctor about the most pronounced the symptoms of arthritis. But a unilateral approach to the disease Reiter's treatment will produce the desired result, and the disease enters a chronic stage.

Measures to get rid of the syndrome can be divided into two parts: antibacterial treatment of infection and therapy of inflammation of joints.

In the course of 6 weeks the patient has to be treated with antibiotics. Drugs changed: 15-20 days used drugs of the same pharmacological group, then another. The tetracyclines, macrolides and fluoroquinolones. Tetracycline antibiotics are well tolerated by patients. Such drugs are well established in the fight against chlamydia. Drugs from fluoroquinolone group inhibit bacteria growth and division of cells. The disadvantages of the application is part of their excessive toxicity. They can't be used for a long time, preferably not more than 2 weeks. There are also age restrictions at their reception.

Particularly important are the antibiotics of macrolide group. They have a good level of bioavailability. Macrolides are effective in the treatment of intracellular infections. Them lends itself to advanced forms of the disease. They can be used for a long period without fearing to cause the patient harm. Antibiotics taken with antifungal medications and vitamins. To maintain the immune system immunomodulators are assigned. And that antibiotic is better penetrated into the kill zone, additionally appointed proteolytic enzymes. Against inflammatory processes in the joints are prescribed nonsteroidal anti-inflammatory drugs and cytostatics.

In the early stages of the disease the doctor may recommend physiotherapy. It begins with gentle exercise. Loadings increase as the recovery of joint function. Muscle atrophy is treated by massage. Patients are advised to undergo a Spa treatment. Eye lesions syndrome Reiter heals ophthalmologist. When skin lesions requires the advice of a dermatologist.

Prevention of disease is primarily based on conventional sanitation. You need time to heal infections of the urinary tract. The main rule is that it is desirable to have a regular sexual partner, to avoid Contracting sexually transmitted diseases.

Reiter's Syndrome in children

In children the disease usually develops after suffering dysentery. Urethritis the child is asymptomatic. The examination also revealed not always. Ocular damage can only be in the form of conjunctivitis. Arthritis is subjected to only a few joints. The symptoms and treatment of disease as its diagnosis in children differ.

Diagnosis is based on complaints of the child and the results of the studies. Diagnosis is enough for the detection of urethritis, arthritis and conjunctivitis, the presence of some symptoms, which the doctor determined by a medical examination. Laboratory tests are assigned for diagnosis or to adjust treatment.

Maybe, for the child it is necessary to conduct analysis of blood and urine, biochemical researches. Sometimes doing x-rays of the joints. Possible MRI and CT scan. For tests for detection of chlamydia scraping is taken from the urethra. To exclude or confirm the diagnosis the doctor may conduct a puncture of the joint capsule with the goal of blood sampling for analysis. Conducted genetic research to identify the antigen.

Summarizing all the results, the doctor develops an individual treatment of the child.