Reactive arthritis is classified as an autoimmune condition that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, oftentimes the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.
The clinical pattern of reactive arthritis commonly consists of an inflammation of fewer than five joints which often includes the knee or sacroiliac joint. The arthritis may be "additive" (more joints become inflamed in addition to the primarily affected one) or "migratory" (new joints become inflamed after the initially inflamed site has already improved).
The arthritis often is coupled with other characteristic symptoms; this is called Reiter's Syndrome or Reiter's arthritis. The manifestations of Reiter's Syndrome include the following triad of symptoms: an inflammatory arthritis of large joints, inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Patients can also present with mucocutaneous lesions, as well as psoriasis-like skin lesions such as circinate balanitis, and keratoderma blennorrhagica. Enthesitis can involve the Achilles tendon resulting in heel pain. Not all affected persons have all the manifestations.
Reactive arthritis is an RF-seronegative, HLA-B27-linked arthritis often precipitated by genitourinary or gastrointestinal infections. The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis or Neisseria gonorrheae).
It most commonly strikes individuals aged 20–40 years of age, is more common in men than in women, and more common in white than in black people. This is owing to the high frequency the of HLA-B27 gene in the white population. Patients with HIV have an increased risk of developing Reactive arthritis as well.
A large number of cases during World Wars I and II focused attention on the triad of arthritis, urethritis, and conjunctivitis (often with additional mucocutaneous lesions) which at that time was also referred to as "Fiessenger-Leroy-Reiter syndrome". These eponyms are now of historic interest only.
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