[Neurologic involvement in Reiter's disease. Report of 2 cases]

Neurologic involvements is a rare complication of Reiter syndrome. It may precede other manifestations and constitutes a cause of death. We report 2 cases. The first, an 18 year-old male developed arthritis, fever, balanitis and sacroileitis 2 months after non gonococcal urethritis. He received phenylbutazone and local steroids without improvement. Logic dysphagia, diplopia with bilateral paralysis of the IV and VI cranial nerves and generalized absent reflexes developed gradually 2 weeks after admission. Methylprednisolone pulses failed to improve the patient's condition and plasmapheresis was associated to near complete remission after 6 exchanges. The other patient, a 31 year old male started out with alternating lower extremity paresis. One month later, urethritis, conjunctivitis, arthritis and sacroileitis appeared. The electromyogram was characteristic of axon sensorimotor polyneuropathy. Administration of naproxen was associated to complete improvement within 2 weeks. Neither patient had shown evidence of recurrence after a 5 year follow up period.