Cardiac conduction abnormalities in Reiter's syndrome

Area of Science:

• Rheumatology
• Cardiology
• Immunogenetics

Background:

• Reiter's syndrome, now known as reactive arthritis, is a spondyloarthropathy.
• It is strongly associated with the B27 antigen.
• Cardiac involvement is a recognized but infrequently discussed complication.

Observation:

• Three male patients presented with cardiac conduction disturbances attributed to Reiter's syndrome.
• Two patients had long-standing, unrecognized disease (over 30 years).
• Cardiac issues included complete heart block, left bundle branch block, and cardiomyopathy.

Findings:

• A chart review of 19 patients revealed five with conduction abnormalities.
• Transient first-degree heart block was common during active disease.
• Conduction abnormalities could also manifest late, with inactive systemic symptoms.
• All affected patients were B27 antigen positive.

Implications:

• The heart may be a target organ in B27-associated spondyloarthropathies, analogous to joints and eyes.
• Cardiac manifestations can have a long latent period, complicating diagnosis.
• Further research is needed to elucidate the mechanism of cardiac involvement.