Ivashkin V T, Polozhentsev S D, Sultanov V K
Klin Med (Mosk). 1992 May-Jun;70(5-6):35-9.
The authors followed up 398 young males with reactive arthritis who had been admitted from organized collectives to hospital settings. Only one third of them could connect the development of reactive arthritis (ReA) with a survived infection: acute nasopharyngeal (26%), acute enterocolitis (7%), urethritis venerea (1%). Analysis of the clinical picture demonstrated that in case of indefinite ReA etiology together with the signs of myocardiac involvement one should not only exclude the presence of rheumatic attack but also to establish a possible relation of the disease with a prior survived poorly manifest intestinal infection. This fact should be taken into account if in the collectives, where from the patients were hospitalized, epidemic outbreaks of acute dysentery or cases of ReA and Reiter's disease etiologically connected with manifest intestinal infection were documented. Postenterocolitic origin of ReA could be suspected in patients with its continuous course and resistance to antiinflammatory therapy in whom arthralgia was preserved for a long time as was joint rigidity after a subsidence of joint changes due to the effect of acute inflammation. Besides, the detection of certain features of the articular syndrome and separate extraarticular signs characteristic of Reiter's disease and other conditions which comprised the group of seronegative HLA--B27-positive spondyloarthropathy are of high diagnostic value.