Reactive arthritis in patients attending an urban sexually transmitted diseases clinic

Arthritis Rheum. 1996 Jul;39(7):1172-7. doi: 10.1002/art.1780390715.

Abstract

Objective: To assess the prevalence, clinical manifestations, associated genital infections, and HLA associations of reactive arthritis (ReA) among patients attending an urban sexually transmitted diseases (STD) clinic.

Methods: Using a standardized questionnaire, 271 consecutive adults, primarily black, with possible or proven Chlamydia trachomatis genital infection were screened for symptoms of ReA. A followup questionnaire was administered 6 weeks later by mail. Patients who reported at least 1 symptom were evaluated by a rheumatologist. HLA-B typing was performed on patients with objective ReA features.

Results: Nine of 217 patients (4.1%) with genital infection/inflammation had objective ReA features. Chlamydial or nongonococcal STD syndromes were diagnosed in 8 of these 9 patients (88%). Genital infection/inflammation was asymptomatic in 78% of patients with ReA features. HLA-B27 or other B7-cross-reactive group antigens were not associated with the occurrence of ReA.

Conclusion: Nongonococcal genital infections, often asymptomatic, can trigger a relatively mild ReA in a larger number of exposed patients than previously thought, irrespective of the individual's HLA status.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alabama / epidemiology
  • Ambulatory Care Facilities*
  • Arthritis, Reactive / complications
  • Arthritis, Reactive / epidemiology*
  • Chlamydia Infections / complications
  • Chlamydia trachomatis
  • Female
  • Gonorrhea / complications
  • HLA-B27 Antigen / analysis
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Sexually Transmitted Diseases / complications*
  • Surveys and Questionnaires
  • Urban Population*

Substances

  • HLA-B27 Antigen