Juvenile onset Reiter's syndrome. A retrospective study of 26 patients.
Clinical, laboratory and radiological findings were evaluated in 26 children with Reiter's syndrome, all of whom met the 1982 diagnostic criteria of A. Calin. Twenty-two of the patients (85%) were male and 4 were female (15%); the mean age at onset was 10.5 years (range 4-15.5 yrs). Mean follow-up time was 28.6 months. Diarrhea prior to onset was observed in 18 cases (69%), but there was no report of venereal disease. The full classic triad was initially observed in only 9 patients (35%), urethritis alone in 6 (23%) and conjunctivitis alone in 4 (15%). Arthritis was present in all patients, with the lower limb joints involved in 25 cases (96%); the pattern was pauciarticular in 18 (69%), polyarticular in 7 (27%) and monoarticular in one (4%). There was complete remission in 15 out of the 26 patients (58%), while a sustained and fluctuating course was seen in 7 (27%) and 3 (11.5%) patients, respectively; a single patient showed a remitting course. Balanitis was present in 11 out of the 22 male (50%) cases. Twelve out of 18 patients tested (67%) proved to be HLA B27 positive and there was radiological evidence of sacroiliitis in 5 out of 24 patients (21%). Reiter's syndrome should be included in the differential diagnosis of the arthritic child. As a rule, the course of joint involvement is remittent and sequelae affecting functional capacity are indeed exceptional.
Cuttica
R J
RJ
Unit of Rheumatology, Hospital de Pediatría Dr. Pedro de Elizalde, Buenos Aires, Argentina.
Scheines
E J
EJ
Garay
S M
SM
Romanelli
M C
MC
Maldonado Cocco
J A
JA
D000293:Adolescent; D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology; D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies
D006680:HLA Antigens