The strange disease that afflicts Nacho Vidal and many other men.
Reiter’s syndrome is a rare rheumatic disease, also known as reactive arthritis, which especially affects men between 15 and 50 years of age.
In this article we will talk about Reiter’s Syndrome, including its causes, symptoms, treatment and preventive options.
What is Reiter’s Syndrome?
Reiter’s syndrome is now known as reactive arthritis. It was discovered by a German physiologistwho conducted experiments in concentration camps, Hans Reiter. It is a systemic disease that affects the individual in multiple ways, most importantly its painful inflammatory rheumatic symptoms that may disappear on their own or become chronic.
It is known as reactive arthritis precisely because of thepainful inflammation of the jointsit produces, which is part of a triad of symptoms that characterize this type of spondyloarthritis: arthritic (rheumatic) symptoms, eye symptoms and urogenital symptoms. There are more symptoms that can occur, but typically these three are found in most cases.
It affects men of Caucasian origin much more frequently, and can appear in a wide range of ages, with a marked peak of affected between 15 and 35 years of age. Approximately one in 30,000 people is affectedby Reiter’s Syndrome, 30% of whom develop serious sequelae that can be disabling – as in the case of the famous porn actor, Nacho Vidal.
- It may interest you: “Knee pain: causes, symptoms and 6 ways to relieve it”
Causes of reactive arthritis
Reactive arthritis is also known as “venereal arthritis” . This is because the disease appears within a few weeks after the patient has contracted a bacterial infection. This infection can be urogenital or enteric, that is, it affects the reproductive/urinary system or the digestive system.
The main bacteria known to be capable of triggering Reiter’s Syndrome are:
- Sexually transmitted, such as Chlamydia trachomatis , which causes chlamydia
- Enteropathogens such as Salmonella, Campylobacter, Yersinia or Shigella
The causal mechanisms of the symptoms of Reiter’s Syndrome are unknown at the moment, but it is known that they are related to bacterial infection . In fact, it is being studied whether Chlamydia, which can cause asymptomatic infections, is related to other types of rheumatic diseases of unclear cause.
What is known about this disease is who is most at risk for it . And it is that 75% of the people who suffer from Reiters Syndrome are carriers of a genetic variant that affects the cells of the immune system, the HLA-B27 allele. This gene generates a protein on the surface of the cell membranes of leukocytes, increasing the risk of autoimmune reactions.
People with the HLA-B27 allele tend to have more severe symptoms and experience the disease in a chronic way, rather than as an isolated event (acute reactive arthritis). That is why it is important to carry out genetic tests on patients with this pathology, since it makes it easier to draw up the action plan against the disease.
Symptoms
The symptoms of Reiter’s Syndrome are very varied, but most cases are characterized by presenting the classic triad of rheumatic, ocular and genitourinary symptoms.
1. Joint symptoms
The inflammatory joint symptoms of reactive arthritis are often the most difficult for the patient to cope with. The inflammation affects a few large joints , such as the knee or sacrum, but can also affect surrounding tendons and joints, such as the Achilles tendon, or the lumbar vertebrae.
These symptoms can last from several weeks to a few months before they subside. In some cases, the disease does not recur, but in others, the symptoms return chronically. A determining factor in the severity of these symptoms is genetic predisposition, that is, the presence of the HLA-B27 allele.
- We recommend: “Tendinitis: causes, symptoms and treatment”
2. Genitourinary symptoms
Reiter’s syndrome includes symptoms in the urinary and reproductive systems , especially in those cases in which it has been acquired through a sexually transmitted infection. In men, an inflammation of the prostate can occur. In women, the inflammation can occur in the cervix, vagina, vulva, or even the fallopian tubes.
Both sexes can present mucous secretions and inflammation of the urethra , accompanied by polyuria -going to the bathroom frequently- or dysuria -pain when urinating-. They are usually the first symptoms to manifest after the initial infection.
3. Eye symptoms
It is common for reactive arthritis to also cause eye problems, such as inflammation of the iris (uveitis) or the appearance of conjunctivitis and photophobia. Over time, especially HLA-B27 carriers may experience more glaucoma or cataract problems. The ocular symptoms of Reiter’s Syndrome are among the most prevalent of its symptoms.
4. Other frequent symptoms
Manifestations of Reiter’s Syndrome sometimes include dermatological symptoms , such as blennorrhagic keratoderma and circinate balanitis, papular lesions with a yellow center, frequently located on the palms of the hands and soles of the feet, although they can affect nails, scrotum or other areas of the body.
In those cases in which the disease has been acquired by an intestinal infection, gastrointestinal disorders such as diarrhea are common. Sometimes there is inflammation of a single finger or several, adopting the so-called “sausage fingers” form. This inflammation causes an abnormal appearance of the digits, as well as pain and difficulty handling them.
Treatment and prevention
The prevention of Reiter’s Syndrome is carried out by controlling two main factors , the safety of sexual contacts (through the use of prophylactics), as well as safety and good hygienic habits when cooking and handling food, such as cleaning kitchen surfaces. In this way we minimize the risk of infection.
In terms of treatment, it also focuses on two main objectives:
- Elimination of the underlying bacterial infection
- Palliation of symptoms
For this, the use of antibiotic therapy is combined with thesubsequent prescription of anti-inflammatory medication. In chronic cases, antirheumatic medication, such as methotrexate, is given to relieve the patient’s discomfort, as well as treatment of the most affected joints with corticosteroids. In those more severe cases, partial immunosuppression may be considered.
References
- Borges-Costa, J., Pacheco, D., Antunes, J., & Sacramento-Marques, M. (2012). Reiter’s syndrome (reactive arthritis). Skin, 27(7), 384-389. doi:10.1016/j.piel.2012.02.007.
- Wu, I., & Schwartz, R. (2008). Reiter’s syndrome: The classic triad and more. Journal Of The American Academy Of Dermatology, 59(1), 113-121. doi:10.1016/j.jaad.2008.02.047.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
