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reactive arthritis -salmonella poisioning
F75. Previously healthy, mobile. I got salmonella poisoning at a breakfast place. Confirmed. 5 weeks later I started to hurt all over.. No history of arthritis. Confirmed as reactive arthritis-only 3 sources- HIV/AIDs, IBS, food borne illness. Mine from the latter. Confirmed by Infectious Disease Specialist. Rheumatologist prescribed Celebrex. One pill and violently ill. Now taking Advil. Not helpful. PCP has no clue what to do next and rheumatologist seems uninterested! Trying to do medical research [used to be called Reiter's]. Has anyone had it or had it treated successfully?
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If you are asking me ... I still have reactive arthritis since being diagnosed when I was 32. Now I'm 70 so 38 years with reactive arthritis.
Prednisone worked well when I was initially diagnosed. The goal of Prednisone is to get the inflammation under control and hopefully reactive arthritis will go into remission and permanently stay in remission.
I was able to get into remission when I took Prednisone but it would only be a temporary remission. My first remission lasted about 5 years but after that I had recurring flares of reactive arthritis every year on average. I needed high dose prednisone for a month for each and every flare to reestablish remission. I could always taper off Prednisone again in about a month.
I treated myself with Prednisone whenever the pain was too severe. Most of the time I would also have a flare of uveitis. The uveitis flares were treated by an ophthalmologist. We developed a routine where I took anywhere between 60 to 100 mg of prednisone each time I had a flare of uveitis. Remission of uveitis was reestablished and I tapered off Prednisone again usually within 1 month. I've had more than 30 flares of uveitis that occurred each time I had a flare of reactive arthritis.
Sometimes I only had reactive arthritis pain without uveitis. That was when I treated myself with prednisone and didn't bother to tell anyone about the pain. When a primary care doctor found out what I had been doing for 20 years ... I was urgently referred to a rheumatologist. That was the first I learned that prednisone was NOT a primary or long-term treatment for reactive arthritis. The rheumatologist wasn't happy with me! Eventually she diagnosed multiple autoimmune conditions and I needed prednisone daily for another 12 years.
Some of my other autoimmune disorders took precedence over reactive arthritis. My rheumatologist lumped them all together and everything was called "widespread systemic inflammation."
I'm off Prednisone now. A biologic that was started for another autoimmune condition is working well for all my autoimmune conditions. Biologics that are considered to be "optimal" and probably work better for reactive arthritis and uveitis are TNF inhibitors. NAIDS like celebrex and then methotrexate and other medications are usually tried before resorting to biologics
https://rheumatology.org/patients/reactive-arthritis
and
https://rheumatology.org/patients/tumor-necrosis-factor-tnf-inhibitors