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Suggest Treatment For Diarrhea While Having Acute Arthritis
Question: Hi our daughter (21) is having some very pronounced joint pain in the shoulders, wrists, fingers, ankles, elbows and with the pain - hives. (This came on suddenly.) She just graduated from nursing school, so things have been very stressful. She went to the university doctor and a battery of blood tests were completed. Everything turned up normal. She was in the hospital three weeks ago due to severe dehydration from food poisoning. We are wondering if it could be a bacterial infection in the digestive system, food or other allergic reactions. We are bringing her home to see our regular doctor who practices internal medicine. I am sure he will run more lab work. What would be your course of action? What specialists should we see? She has been very healthy otherwise.
Brief Answer:
Reactive Arthritis (ReA)-most likely
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
History wise she is having Reactive Arthritis (ReA) as she has acute arthritis preceded by an episode of diarrhea ( She was in the hospital three weeks ago due to severe dehydration from food poisoning). Presumably the episode was enteric infection with any of several Shigella, Salmonella, Yersinia, and Campylobacter species,from which she recovered.
Arthritis is usually asymmetric and additive, with involvement of new joints occurring over a few days to 1–2 weeks.The wrist and fingers can be involved as well. Mucocutaneous lesions are frequent. The most common age range of ReA is 18–40 years (your daughter is 21 years).
You can upload some of the skin lesions without compromise and the reports of the investigations which she has already undergone.
ReA is a clinical diagnosis with no definitively diagnostic laboratory
test or radiographic finding.
NSAIDs (Nonsteroidal anti-inflammatory drugs) remain the initial drug of choice along with proton pump inhibitors (PPIs).
ReA is self-limiting and arthritis typically persists for 3–5 months.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Reactive Arthritis (ReA)-most likely
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
History wise she is having Reactive Arthritis (ReA) as she has acute arthritis preceded by an episode of diarrhea ( She was in the hospital three weeks ago due to severe dehydration from food poisoning). Presumably the episode was enteric infection with any of several Shigella, Salmonella, Yersinia, and Campylobacter species,from which she recovered.
Arthritis is usually asymmetric and additive, with involvement of new joints occurring over a few days to 1–2 weeks.The wrist and fingers can be involved as well. Mucocutaneous lesions are frequent. The most common age range of ReA is 18–40 years (your daughter is 21 years).
You can upload some of the skin lesions without compromise and the reports of the investigations which she has already undergone.
ReA is a clinical diagnosis with no definitively diagnostic laboratory
test or radiographic finding.
NSAIDs (Nonsteroidal anti-inflammatory drugs) remain the initial drug of choice along with proton pump inhibitors (PPIs).
ReA is self-limiting and arthritis typically persists for 3–5 months.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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