Reactive Arthritis - Reiter's Syndrome

Reiter's syndrome is a condition that causes arthritis in people who are genetically susceptible. It may also affect the eyes and the urethra, the tube that drains urine from the bladder.

What is going on in the body?

Reiter's syndrome refers to a condition in which a person develops acute arthritis in response to an infection. The affected joints involved in the arthritis do not contain infection. The immune system causes inflammation of the joints in response to an infection in a person with Reiter's syndrome. Reiter's syndrome may be seen following many different infections, including:

What are the causes and risks of the condition?

For unknown reasons, certain people are genetically susceptible to Reiter's syndrome. Eighty percent of the people with Reiter's syndrome have a gene known as HLA-B27. These individuals are at risk for Reiter's syndrome following an infection with certain bacteria or viruses, including:

Reiter's syndrome is most commonly seen in men between the ages of 20 and 40 years. While women can develop the condition, they usually have milder symptoms than the men do.

What are the signs and symptoms of the condition?

Typically the symptoms of Reiter's syndrome begin 7 to 14 days after the initial infection.

How is the condition diagnosed?

Reiter's syndrome may be suspected when someone develops arthritis following an infection. The organism may be cultured from the throat, intestinal tract, or genitourinary tract. Blood tests can help confirm the diagnosis. In some cases, a joint aspiration is done to remove fluid from the joints by a needle. The fluid is then examined under a microscope in the laboratory.

What can be done to prevent the condition?

Practicing safer sex can eliminate some cases of Reiter's syndrome caused by a sexually-transmitted disease. Reiter's syndrome that follows food poisoning can be avoided by using good food-handling techniques.

What are the long-term effects of the condition?

Although most people recover completely from Reiter's syndrome, about 20% may be left with ongoing joint pain. Some individuals may develop chronic eye irritation known as uveitis,. Ten percent of the people who have Reiter's syndrome will develop heart valve problems, including aortic regurgitation. Rarely, the syndrome may cause severe arthritis and disability.

What are the risks to others?

The original infection, which triggers Reiter's syndrome, can be spread to others. However, not all people will develop Reiter's syndrome as a result of the infection.

What are the treatments for the condition?

When Reiter's syndrome is first diagnosed, a short period of bed rest may be recommended to reduce pain and inflammation in the joints. The healthcare provider may then recommend strengthening and range-of-motion exercises .

Following are some of the medications used to treat Reiter's syndrome:

What are the side effects of the treatments?

Antibiotics may cause stomach upset, diarrhea, and allergic reaction. NSAIDs can cause stomach upset and allergic reactions. Steroids may cause weight gain, high blood pressure, and an increased risk of infection.

What happens after treatment for the condition?

Arthritis symptoms may continue for up to six months. Most people recover in 2 to 16 weeks, but some have recurrent flare-ups and remissions.

How is the condition monitored?

Repeated physical examinations and blood tests help monitor Reiter's syndrome. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Bill Harrison, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:03/30/01
Reviewer:Barbara Mallari, RN, BSN, PHN
Date Reviewed:08/06/01

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