REITER'S DISEASE IN CHILDREN

Abstract

This article analyzes the modern medical interpretation of the condition historically referred to as Reiter's disease in children, namely the etiopathogenesis of reactive arthritis, its clinical presentation, diagnostic algorithm, principles of differential diagnosis, and treatment approaches. It shows that in pediatric practice this syndrome does not fully correspond to the classic adult urogenital form, that in most cases it develops after enteric infections, most often affects the joints of the lower limbs asymmetrically, and is accompanied by enthesitis, conjunctivitis, and cutaneous and mucosal manifestations. Special attention is paid to terminology: although the term “Reiter's disease” is historically well known, the term “reactive arthritis” is considered more precise and acceptable in contemporary scientific literature. Although the course of the disease in children is usually relatively mild and self-limited, in some patients recurrence, progression to enthesitis-related arthritis, or a tendency toward chronic inflammatory spondyloarthropathy may develop. For this reason, early diagnosis, differentiation from septic arthritis and juvenile idiopathic arthritis, identification of the infectious source, and the selection of a stepwise therapeutic strategy require cooperation among the pediatrician, rheumatologist, ophthalmologist, and infectious disease specialist.