Reactive Arthritis

reactive arthritis, formerly known as Reiter syndrome, disorder characterized primarily by joint pain that also sometimes affects the eyes, urogenital tract, and skin on the palms of the hands and soles of the feet. The cause of reactive arthritis is unclear, but symptoms typically are triggered by a sexually transmitted disease or a gastrointestinal infection. Presumably, reactive arthritis reflects an aberrant immune response to various infectious agents, such as Chlamydia, Campylobacter, Shigella, and other bacteria that occur in the genitals or gastrointestinal tract, but the mechanisms are unknown.

Reactive arthritis is rare. It occurs most commonly in males between the ages of 20 and 50. A genetic factor (HLA-B27) has been identified that predisposes a person to the disorder. In individuals who carry HLA-B27, symptoms of reactive arthritis may appear suddenly and often are more severe than in persons who are HLA-B27-negative. The condition also tends to affect individuals with weakened immune systems.

Reactive arthritis usually involves multiple joints, particularly the knees, ankles, and bones of the feet. In most cases, the joint pain seems to resolve spontaneously in a few months, but it has a tendency to recur episodically. Occasionally, severe complications such as heart damage may occur, but death from the syndrome is rare. Treatment of the original infection with antibiotics is important but does not prevent reactive arthritis from occurring.