淋菌性尿道炎後に発症したライター症候群

Gonorrheal urethritis followed by Reiter syndrome：A case report

　症例は19歳，男性。排尿時痛を主訴に当科を受診した。淋菌性尿道炎の診断に至り，抗生剤を投与したが，その2日後に両足関節の有痛性腫大が出現した。結膜炎所見も観察され，ライター症候群（Reiter syndrome）の診断にて入院となった。リウマトイド因子 （rheumatoid factor：RF），抗核抗体，HLA-B27はいずれも陰性であった。炎症所見および多発性関節炎の遷延を認めたが，ステロイド投与後徐々に軽快し，入院70日目にして退院となった。

　A 19 year-old man came to our outpatient clinic with the chief complaint of miction pain. The diagnosis was gonorrheal urethritis. He developed right knee arthritis, bilateral conjunctivitis two days after the injection of antibiotics. These symptoms were consistent to the features of Reiter syndrome. Bacterial culture of urine was negative, as were rheumatoid factor（RF）and HLA-B27 antigens. After the initiation of treatment with corticosteroids, all symptoms were gradually improved and eventually resolved. Reiter syndrome is a rare disease with the triad of arthritis, urethritis and conjunctivitis. Recognition of this uncommon disease is important to facilitate early treatment and recovery.（Rinsho Hinyokika 61：745-747, 2007）