Reiter's Syndrome

Reiter’s syndrome is also known as the reactive arthritis. It is a rheumatic disease, which typically occurs in young men. The underlying mechanism is not completely clear, but at least we know some causative factors.


Reiter's syndrome usually occurs in a certain time period after an infectious disease, usually an infectious diarrhea or urethritis caused by chlamydia. The infections somehow reprogram our immune system, which subsequently attacks our own tissues. However, this situation happens only in some people who have certain genetic predisposition (such as people with HLA-B27 positive antigen system).


The syndrome classically manifests with a clinical triad including non-infectious arthritis, urethritis and conjunctivitis. The inflammation can affect various joints such as the small joints of the hand, knee joint or intervertebral joints manifesting with joint swelling, pain and stiffness. Tendons are also often affected. Conjunctivitis causes redness and pain in the affected eye. Uncomfortable is the inflammation of urethra, which may be accompanied by inflammation of prostate in men or cervix in women. The main symptoms are burning pain during urination and pain during intercourse. Intermittent discharge from the urethra may resemble gonorrhea.


The diagnosis is based on finding the symptoms listed above occurring in a patient who recently suffered from infectious diarrhea or infectious urethritis. When diagnosed, it is advisable to exclude continuous presence of chlamydial urethritis.


The therapy is mainly symptomatic. Rest and avoiding physical exercise are recommended, the joint and eye troubles may be treated by anti-inflammatory drugs that are administered in form of tablets, ointments or eye drops. If we find a persisting infection that has caused the Reiter’s syndrome, it is treated by antibiotics (if bacterial or chlamydial).


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources