Liao Chiang-Hua, Huang Jing-Long, Yeh Kuo-Wei
Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Dec;37(6):379-81.
Reiter's syndrome (RS) is uncommon in children, and the classic triad manifestations of RS usually do not occur simultaneously in children. It is often clinically confused with other childhood illnesses. We report a case of RS in a 7-year-old boy with a family history of ankylosing spondylitis. He had developed intermittent arthralgia of the right knee for about 6 months and occasional bilateral eye pain for several months prior to admission. In the 5 days before admission, he developed multiple oral ulcers, weight loss from 25 to 22 kg and fever. Physical examination showed injected bilateral conjunctivae and the right knee joint with swelling, local warmth, and tenderness over the patellar ligament. Laboratory results revealed positive histocompatibility antigen-B27 (HLA-B27), negative rheumatoid factor (RF) and antinuclear antibody (ANA) and normal urinalysis. RS was diagnosed based on the findings of both arthritis and conjunctivitis. The arthritis was treated with acetaminophen and naproxen. In conclusion, juvenile RS should be considered in children with arthritis and conjunctivitis, positive HLA-B27, negative RF and ANA and a family history of related diseases.
赖特综合征（RS）在儿童中并不常见，且RS的典型三联征表现通常不会在儿童中同时出现。它在临床上常与其他儿童疾病相混淆。我们报告一例7岁男孩患RS，其有强直性脊柱炎家族史。入院前约6个月，他出现右膝关节间歇性关节痛，入院前数月偶尔出现双侧眼痛。入院前5天，他出现多处口腔溃疡、体重从25千克降至22千克并发热。体格检查显示双侧结膜充血，右膝关节肿胀、局部发热，髌韧带压痛。实验室检查结果显示组织相容性抗原-B27（HLA-B27）阳性，类风湿因子（RF）和抗核抗体（ANA）阴性，尿液分析正常。根据关节炎和结膜炎的表现诊断为RS。关节炎采用对乙酰氨基酚和萘普生治疗。总之，对于有关节炎和结膜炎、HLA-B27阳性、RF和ANA阴性且有相关疾病家族史的儿童，应考虑青少年RS。
