Gill Himmat, Majithia Vikas
Department of Medicine, Division of Rheumatology, University of Mississippi Medical center, 2500 N State Street, Jackson, MS 39216, USA.
Clin Rheumatol. 2008 Jan;27(1):121-3. doi: 10.1007/s10067-007-0692-0. Epub 2007 Jul 21.
Reiter's syndrome is one of the reactive forms of seronegative spondyloarthropathies. Various therapies used in the management of Reiter's syndrome are nonsteroidal antiinflammatory drugs (NSAIDs), antibiotics, and disease-modifying antirheumatic drugs (DMARDs) such as sulfasalazine (SSZ) or methotrexate (MTX). There is only one case report of successful treatment of Reiter's syndrome with tumor necrosis factor-alpha (TNF-alpha) blockers in human immunodeficiency virus (HIV) patient (Gaylis N, 2003, J Rheumatol 30(2):407-411 Feb). We hereby report a case of Reiter's syndrome treated successfully with infliximab, an anti-TNF-alpha chimeric monoclonal antibody. A 28-year-old white male presented with painful swelling of right elbow and ankle joints, urethritis. and lesions involving skin of soles of feet and penis. Detailed work-up of sexually transmitted diseases (STDs), HIV, and systemic etiology were negative. Despite aggressive treatment with antibiotics, NSAIDS, prednisone, and MTX for 3 months, he had persistent synovitis and worsening of skin lesions. He was then treated with infliximab 200 mg intravenously at weeks 0, 2, 6, and 14 weeks which resulted in complete resolution of arthritis and skin lesions within 6 weeks of infliximab therapy.
赖特综合征是血清阴性脊柱关节病的反应性形式之一。用于治疗赖特综合征的各种疗法包括非甾体抗炎药（NSAIDs）、抗生素以及改善病情抗风湿药（DMARDs），如柳氮磺胺吡啶（SSZ）或甲氨蝶呤（MTX）。在人类免疫缺陷病毒（HIV）患者中，仅有一例使用肿瘤坏死因子-α（TNF-α）阻滞剂成功治疗赖特综合征的病例报告（Gaylis N，2003年，《风湿病学杂志》30(2):407 - 411，2月）。我们在此报告一例使用抗TNF-α嵌合单克隆抗体英夫利昔单抗成功治疗的赖特综合征病例。一名28岁白人男性出现右肘关节和踝关节疼痛肿胀、尿道炎以及累及脚底和阴茎皮肤的病变。性传播疾病（STDs）、HIV及全身病因的详细检查均为阴性。尽管使用抗生素、NSAIDs、泼尼松和MTX积极治疗3个月，他仍持续存在滑膜炎且皮肤病变恶化。随后在第0、2、6和14周静脉注射英夫利昔单抗200 mg对其进行治疗，结果在英夫利昔单抗治疗6周内关节炎和皮肤病变完全消退。
