Reactive arthritis ( Reiter's syndrome ) - Causes, Symptoms and Treatment .MF .
Many human diseases are associated with an infection, but not directly.A striking example - reactive arthritis .joint infections there, it affects the genitourinary or gastrointestinal tract.However, it affects the joints.Infection appears a "trigger" that disrupts the immune system, and it is the latest "attack" on the joints.Therefore, even the elimination of the infection with antibiotics does not always help to get rid of problems.
term « reactive arthritis » (ie, joint inflammation, which occurs as a reaction, a response to an infection elsewhere) was proposed in 1969 Anhovenom.It is interesting that until recently the disease was named after German physician Hans Reiter (who first described this combination of symptoms), but the latter was a supporter of the Nazis and eugenics, took part in experiments on humans at concentration camps.Therefore, preference is now given to it the term "reactive arthritis."
Understanding reactive arthritis
Reactive arthritis (Reiter's syndrome) - an inflammator
Reactive arthritis is not associated with the spread of infection through the body and its release to the joint.It is believed that the joint inflammation develops due to the fact that the microorganisms contain substances (antigens), antigens which are similar to the body's tissues.The immune system "confuses" the joint antigens and microorganisms, as a result of it and germ attacks, and joint.The joint inflammation develops, and that causes problems.
symptoms of reactive arthritis
Three classic symptoms of reactive arthritis: inflammation of the eye (conjunctivitis - eye redness, burning sensation in the eyes, watery eyes), inflammation of the urinary tract (urethritis - pain or burning during urination, frequent urination), and inflammation of the joints (arthritis -joint pain, their redness, swelling, hot joints, the mobility is limited).
reactive arthritis usually begins 2-4 weeks after intestinal or venereal infection.The most common first symptom is urethritis, conjunctivitis then developed, and the last - arthritis.Approximately every fourth patient, there are changes in the skin of different appearance.
symptoms of reactive arthritis is usually stored from three to twelve months.In most cases, the symptoms of conjunctivitis and urethritis expressed very poorly and only 1-2 inflamed joint.Some patients, however, reactive arthritis can be acute and severe, limit their physical activity.
relapses (repeated exacerbations) are rare.
Causes of reactive arthritis
most often reactive arthritis associated with microorganisms, called chlamydia.Hladimii usually transmitted through sexual contact.Often the infection has no symptoms, but the most frequent symptoms (if present) - pain or discomfort during urination and discharge from the penis or vagina.
addition, reactive arthritis can cause the bacteria affecting the digestive tract: Salmonella, Shigella, Yersinia and Campylobacter.The symptoms of lesions of the gastrointestinal tract are severe diarrhea with blood and mucus in the stool.Infection occurs due to incorrect reception of cooked food in contact with infected people or faeces (microorganism should get into the gastrointestinal tract).
Reactive arthritis develops not all people after undergoing an infection.The reasons for this are unclear selectivity.It is shown that the disease often develops in people who have a special gene - HLA B 27 (Al-Al-Be-A 27).
Risk Factors reactive arthritis
Reactive arthritis most often affects people between the ages of 20-40 years.Interestingly, after infections, sexually transmitted diseases, the man sick nine times more often than women, while intestinal infections after the danger of the same.Men suffer slightly heavier women.
increased risk in individuals with HLA B 27, but his research to the development of the disease is not necessary.
diagnosis of reactive arthritis
simple and straightforward test that allows to establish the diagnosis of reactive arthritis is not there yet.A doctor may suspect the diagnosis at the correct patient questioning and examination, and then assign a special study to confirm it.
- On examination, special attention is paid to the detection of signs of joint damage, eyes, urinary tract, skin.
- Special studies are needed for two reasons: to confirm the diagnosis of reactive arthritis, and to exclude other causes of arthritis.
- Arthritis often increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP);These tests indicate the presence of inflammation in the body.
- studies for rheumatoid factor (RF) and antinuclear factor (ANF) with reactive arthritis are negative.Detection of HLA
- 27 - argument in favor of reactive arthritis.
- Research on infection (Chlamydia, Yersinia, etc.) Is of great importance, as it allows to discover the probable cause of the disease.Explore may discharge from the genital tract, blood, stool, etc..
- To exclude an infection in the joint (arthritis bacterial) sometimes perform joint puncture and examined him taken out of the fluid (synovial fluid).
- X-rays can be used to assess the condition of the joint, but clearly establish the cause of joint inflammation, it allows infrequently.
reactive arthritis Treatment
Treatment reactive arthritis predominantly directed at relieving symptoms.
If symptoms persist active infection, then antibiotics is justified in order to eliminate the bacteria and remove the root cause of inflammation.
Nonsteroidal anti-inflammatory drugs (eg ibuprofen, diclofenac, indomethacin, etc.) Reduce pain and inflammation of the joints.
In severe inflammation of the joints sometimes perform injection in these glucocorticoids (anti-hormones).
prescribe anti-inflammatory drugs that slow joint damage With long-term preservation of joint pain - sulfasalazine, methotrexate, and others.
During active inflammation joint should be protected from stress.However, after the relief recommended by the gradual recovery of physical activity.