The Chronicity of Symptoms and Disability in Reiter's Syndrome

Abstract

To assess the natural history of Reiter's disease, we evaluated 131 consecutive patients at a university clinic or at a community center. One hundred twenty-two patients (93%) were available for follow-up at a mean of 5.6 years. The results showed that there were no major differences between patients at the two centers; at follow-up, 101 (83%) had some disease activity, 27 (22%) had annoying symptoms, 42 (34%) had sustained disease activity, 19 (16%) had had to change jobs, and 13 (11%) were unemployable; there were no major differences between the 19 (15%) females and 112 (85%) males or between the HLA-B27-positive (83%) and -negative (17%) patients, except for increased prevalence of sacroilitis and chronic uveitis in HLA-B27-positive patients; and, at entry, only increased heel disease differentiated those destined to have a poor prognosis. Most patients with Reiter's syndrome have persisting symptoms that can lead to chronic disability.

Ten‐year followup study of patients with yersinia arthritis

“…The good initial prognosis of reactive arthritis may be changed if there are recurrent attacks of arthritis. Recurrent attacks of Reiter's syndrome are common in patients with uroarthritis (18,19), but occurred infrequently in the present patient series. We have also observed a less favorable prognosis of peripheral arthritis in patients with Reiter's disease, compared with patients with Yersiniu arthritis (20).…”

“…Sacroiliitis has also been observed during the onset of Reiter's syndrome; after a mean of 10 years, a third of the patients had radiologic changes of sacroiliitis (28). This is in accordance with the longterm prognosis of Shigella enteroarthritis (17), but higher (19) and lower (1 8) figures have been reported for venereal Reiter's syndrome, in which the progression of sacroiliac changes is very slow (28,29).…”

Followup study on patients with reiter's disease and reactive arthritis, with special reference to HLA—B27

“…Some authors have reported that B27-positive patients have a more chronic or relapsing course of Reiter's disease (41), a more prolonged acute disease, and more frequent extraarticular symptoms (11), whereas others have found no differences between the patient groups (42,43). The predominance of radiologic sacroiliitis in B27-positive patients with Reiter's disease or yersinia arthritis has been shown by several authors (14,27,36,44). The discrepancy in the influence of B27 on the clinical picture of yersinia arthritis and Reiter's disease is probably explained by the fact that the diagnosis of Reiter's disease already includes the patients with some extraarticular symptoms, i.e., patients with a complicated disease.…”

Humoral Immune Response in Yersinia enterocolitica O:5 Induced Arthritis in Hamsters

“…However, later studies have revealed that 40-80% of the patients suffered from a variety of chronic disorders related to initial arthritis (7,19,22,24). The role of immune response in the pathogenesis of these sequelae has not been totally defined (3).…”