Correlations between infection patterns and eye damage in reactive arthritis.

The purpose of the study was to correlate the infectious patterns (urogenital, enteral) with ocular manifestations, such as conjunctivitis or acute anterior uveitis in reactive arthritis (ReA). The transversal, observational study was conducted in the Clinic of Rheumatology, University of Medicine and Pharmacy of Craiova, Romania, during the period 2012-2015, and included 112 patients. They were divided into three groups, as follows: Group I (52 ReA cases), Group II (30 other spondyloarthritis cases), Group III (40 osteoarthritis cases). Ophthalmologic screening was performed, together with the detection of human leukocyte antigen B27 (HLA-B27) and the infectious trigger. Within Group I, 42 (80.76%) patients presented genitourinary infections (78.57% Chlamydia trachomatis, 21.43% Ureaplasma urealyticum), 10 (19.23%) patients presented enteral infections (Yersinia enterocolitica and Salmonella). Compared with the other two groups, the patients from the first group were documented with more conjunctivitis episodes. Although anterior uveitis is more common in ankylosing spondylitis (AS), in the present study more cases were identified in Group I (11.9%) than in Group II (6.67%) and no case were recorded in Group III. Most of patients from Group I were HLA-B27 positive. The etiologic profile of ocular manifestations in ReA is dominated by genitourinary infections - C. trachomatis and U. urealyticum, respectively. Cases of recurring uveitis are associated with elevated levels of anti-immunoglobulin A (IgA).