What is Reiter’s syndrome?

  Reiter’s syndrome is a specific clinical type of reactive arthritis characterized by a triad of arthritis, urethritis, and conjunctivitis, often presenting as sudden acute arthritis with distinctive extra-articular skin and mucosal symptoms. The triad of arthritis, non-gonococcal urethritis and conjunctivitis with diarrhea and bloody stools was subsequently named Wright’s syndrome by Bauer and Engleman in 1942.  The disease is now considered to have two forms: the sexually transmitted form and the dysentery form. The former is seen mainly in young men between 20 and 40 years of age and occurs in most cases after urinary tract infection and genital infection by Chlamydia trachomatis or Mycoplasma protozoa. Wright’s syndrome is rare in women, children and the elderly, they usually occur after an intestinal bacterial infection, called the dysentery type, and the intestinal infections are mostly gram-negative bacilli, including are Shigella spp, Salmonella spp, Yersinia spp and Campylobacter spp.  The development of Wright syndrome is associated with infection, genetic markers (HLA-B27) and immune dysregulation. There is an increased incidence of sacroiliac arthritis, ankylosing spondylitis and psoriasis in relatives of patients. The pathological changes of the synovium are non-specific inflammation. In the acute phase, there is synovial vascular congestion, fibrinous exudate, neutrophilic polymorphonuclear leukocytes, lymphocytes and plasma cell infiltration, and synovial cell and fibroblast proliferation. In the chronic phase, there is vascular opacification and cartilage erosion, sometimes accompanied by osteolysis and new bone formation. The disease is most common in young men, and the prevalence abroad varies from 0.06% to 1%, while no statistical data are available in China.