Genetic marker for reiters syndrome
Correct Answer: HLA B27
Description: Reiters syndrome/ flies singer-Leroy disease: traid of urethritis , ahritis conjunctivitis Genetic predisposition: hla b 27 Causative organisms: Chlamydia trachomatis Salmonella Campylobacter Yersinia Shigella Clostridium diff iCal eah Clinical features: chronological appearance First manifestations: urethritis,conjunctivitis Ahritis Circulate Balan it is Ahritis: asymmetric , oligoaicular-predilection to lower extremity large joints, enthesitis( inflammation of tendons and ligaments at the sites of inseion into capsule or bone),sacroilitis. Rapid development of massive effusions. Sausage digitis-diffuse swelling of solitary finger or toe Joints: early morning stiffness and pain. Genitourinary: nonspecific urethritis, cervicitis, cystitis, hematuria, hydronephrosis,prostatitis, baholinitis,vaginitis, salpingitis Eye lesions: conjunctivitis,uveitis,iridocyclitis Cutaneous: keratoderma blemorrhagicum-hyper keratotic pustular lesions on erythematous base involving palms and soles.crusted thick horny lesions with thick scales circulate Balanitis-most common irregular moist superficial erosions or ulcers coalesce to form circinate lesions. ulceration over tongue-painless Cardiac: aoic is and hea block Renal- glomerulonephritis Investigations: Elevated acute phase reactants Elevated esr Jointfluid-pseudo sepsis- neutrophils>50000/ul, with reiters cells Radiology: enthesitis with periosteum reaction, asymmetric sacroilitis, spondylitis, non marginal syndesmophytes Conditions to be differentiated from reactive ahritis Treatment Ahritis: Physiotherapy, nsaids,indomethacin is the drug of choice. Dmards-sulfasalazine, methotrexate,hydroxychloroquine,prednisolone,acitretin in hiv patients Biological: infliximab,etanercept Cyclosporine, levamisole,gold,pencillamine. Skin and mucus membranes: topical keratolytis, topical coicosteroids,methotrexate,acetretin Iadvl textbook of dermatology page 2088
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