Reiter's syndrome

Reiter's syndrome (N. Reiter; synonym of retro-oculo-virus syndrome) is a disease characterized by the triad of symptoms: joint affection, urinary tract and eyes.
The etiology and pathogenesis is unknown. Reuters, Paronen (L. Paronen) and others have observed this syndrome after suffering dysentery, other authors have noted his rheumatism, tuberculosis, syphilis, ulcerative colitis, etc.
In this triad of symptoms the most common lesions of joints, especially large: the degree of manifestation of these lesions range from small pain to severe deformations with swelling, damage tendons, periosteum, prolonged abnormal function of the joints. For arthritis resistant prone to relapse. Biopsy of the synovium note inflammatory changes similar to those observed in infectious arthritis. The radiological examination of the joints - moderate osteoporosis, sometimes narrowing of the joint space. Frequent bilateral conjunctivitis, but may occur more severe eye injury - episclerit, irity, iridotsiklity, sometimes leading to irreversible damage of view. The defeat of the urinary tract appears most often urethritis, but it may cause cystitis, pyelonephritis, occurring in some cases with symptoms of kidney failure. It is also possible dry pleurisy, myocarditis, pericarditis, rhinitis, stomatitis, diarrhoea disorders. Skin lesions (by type of keratosis) begin acute eruption of vesicles on the inflamed basis. Sometimes bubbles poorly expressed; sometimes they turn into pustules, and then to brown. Explicit exudation stops and begin to form scales, resembling a horn, usually on the skin of the hands and feet, especially on the palms and soles, where novopodillia layers resemble obojnymi nails. Rash possible, and in other parts of the body. All these phenomena are very similar in the gonorrheal keratosis.
Typical triad observed in most patients, some can be combined only two symptom and less likely to have only one symptom (joint or eye).
In the acute period of the disease are observed increase in temperature to 38-39 degrees, the deterioration of the General condition, leukocytosis, sometimes with a shift to the left, and a significant acceleration ROHE. The highest ROE is observed with the combination of all three symptoms.
Treatment: antibiotics (penicillin, biomitsin, syntomycin) in normal doses; to influence changes in the joints - ACTH (30-40 IU / day) or steroids (cortisone 100 mg, prednisolone 15-20 mg, triamcinolon 12-16 mg / day) and pyrazolone drugs (phenylbutazone, reopirin in table 2-4. a day).