送交者: xj 于 2005-11-09, 17:44:57:
回答: 学医的看过来 "£1.2m for Chinese meal poisoning" 由 妖魔 于 2005-11-09, 16:34:41:
What is Reiter’s Syndrome?
Reiter’s syndrome, a form of reactive arthritis, is an uncommon but debilitating syndrome caused by gastrointestinal or genitourinary infections. The most common gastrointestinal bacteria involved are Salmonella, Campylobacter, Yersinia, and Shigella. Reiter’s syndrome is characterized by a triad of arthritis, conjunctivitis, and urethritis, although not all three symptoms occur in all affected individuals (Hill Gaston and Lillicrap, 2003). The reactive arthritis associated with Reiter’s may develop after a person eats food that has been tainted with bacteria. Although the initial infection may not be recognized, reactive arthritis can still occur. Reactive arthritis typically involves inflammation of one joint (monoarthritis) or four or fewer joints (oligoarthritis), preferentially affecting those of the lower extremities; the pattern of joint involvement is usually asymmetric. Inflammation is common at enthuses (places where ligaments and tendons attach to bone), especially the knee and the ankle.
Salmonella has been the most frequently studied bacteria associated with reactive arthritis. Overall, studies have found rates of Salmonella-associated reactive arthritis to vary between 6 and 30% (Hill Gaston and Lillicrap, 2003). The frequency of postinfectious Reiter’s syndrome, however, has not been well described. In a Washington State study, while 29% developed arthritis, only 3% developed the triad of symptoms associated with Reiter’s syndrome (Dworkin, et al, 2001). In addition, individuals of Caucasian descent may be more likely those of Asian descent to develop reactive arthritis (McColl et al, 2000), and children may be less susceptible than adults to reactive arthritis following infection with Salmonella (Rudwaleit, et al, 2001).
A clear association has been made between reactive arthritis and a genetic factor called the human leukocyte antigen (HLA) B27 genotype. HLA is the major histocompatibility complex in humans; these are proteins present on the surface of all body cells that contain a nucleus, and are in especially high concentrations in white blood cells (leukocytes). It is thought that HLA-B27 may affect the elimination of the infecting bacteria or an individual’s immune response (Hill Gaston and Lillicrap, 2003). HLA-B27 has been shown to be a predisposing factor in one-half to over two-thirds of individuals with reactive arthritis.(Hill Gaston and Lillicrap, 2003; Barth and Segal, 1999), While HLA-B27 does not appear to predispose to the initial infection itself, it increases the risk of developing arthritis that is more likely to be severe and prolonged. This risk may be slightly greater for Salmonella and Yersinia-associated arthritis than with Campylobacter, but more research is required to clarify this (Hill Gaston and Lillicrap, 2003).