All are seen in reiter’s syndrome except ?
**Core Concept**
Reiter's syndrome, also known as reactive arthritis, is a type of arthritis that occurs as a reaction to an infection elsewhere in the body, typically in the gastrointestinal tract or the urethra. It is characterized by a triad of symptoms: arthritis, urethritis, and conjunctivitis.
**Why the Correct Answer is Right**
Reiter's syndrome is a form of seronegative spondyloarthropathy, which means that it does not involve the production of rheumatoid factor antibodies. The exact pathogenesis of Reiter's syndrome is not fully understood, but it is thought to involve an abnormal immune response to the triggering infection, leading to inflammation and tissue damage in the affected joints, eyes, and urinary tract. The condition is often associated with the presence of HLA-B27 antigen.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because arthritis is one of the hallmark symptoms of Reiter's syndrome.
**Option B:** This option is incorrect because urethritis, which is inflammation of the urethra, is a common feature of Reiter's syndrome.
**Option C:** This option is incorrect because conjunctivitis, which is inflammation of the conjunctiva, is another symptom of Reiter's syndrome.
**Clinical Pearl / High-Yield Fact**
Reiter's syndrome is often triggered by bacterial infections such as Chlamydia trachomatis, Salmonella, and Shigella. It is also more common in individuals who are HLA-B27 positive.
**Correct Answer:** D