Rieter's Disease in Females

Abstract

In Reiter's disease, a type of reactive arthritis, male predominance has been reported ranging from 85 to 88 percent. This study was conducted in Base Hospital, Barrackpore (Kolkata). One hundred and sixty six Reiter's disease cases were diagnosed as per the American Rheumatological Society criteria, and of these 125 (75.32%) female cases were analyzed further. Average duration of arthritis in females was 6.68 years (range one month to 36 years) and average age of onset was 39.35 (range 19–63) years with majority being in the fourth (38.4%) and the fifth (24.0%) decade. Pelvic inflammatory disease (including 91 with Fitz-Hugh-Curtis syndrome) was present in 114 (91.2%), cervicitis in 6(4.8%). Arthritis knee, radiological involvement of calcaneum, lumbar and cervical spine and periarthritis shoulder were found in 56.8%, 86.4%, 44.8%, 31.2% and 15.2% cases respectively. Conjugal Reiter's disease was present in 4.8%. Idiopathic hypothyroidism was seen in 12.8%. There was higher ratio of females with Reiter's disease in our study which was opposite to often-reported male to female ratio. It appears that Reiter's disease in females is highly under diagnosed, is likely to be milder, chronic and of later onset. Presence of PID should be looked into meticulously in cases of seronegative spondyloarthropathies. A significant association has also been found with idiopathic hypothyroidism.