Reactive Arthritis

Basics

Description

  • Possibly 1st described in the 4th century bc by Hippocrates
  • Reactive arthritis (ReA) is part of the spectrum of spondyloarthropathies
  • Characterized by triad of conjunctivitis, urethritis, and arthritis
  • Syndrome classically includes triad of conjunctivitis, urethritis, arthritis
  • Previously known as “Reiter syndrome,” and now referred to as ReA according to the American College of Rheumatology:
    • Typically taught as the syndrome of “can't see, can't pee, can't climb a tree”
  • Can be accompanied by other extra-articular manifestations
  • More common in adult males

Etiology

  • Infection-induced systemic illness
  • Genetic predisposition in HLA-B27 carriers
  • Exact incidence difficult to determine because of lack of standardized diagnostic criteria
  • Typically occurs after infection with gastrointestinal or genitourinary pathogens:
    • GI:
      • Salmonella, Shigella, Campylobacter, Yersinia, Clostridium difficile
    • GU:
      • Chlamydia trachomatis (most common cause), Neisseria gonorrhoeae
  • Also described after upper respiratory infections, UTIs, BCG treatment for bladder carcinoma
  • Peak onset during 3rd decade

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