Tropical arthritis in Papua New Guinea: a reactive arthritis

Med J Aust. 1990 Feb 19;152(4):186, 188-9. doi: 10.5694/j.1326-5377.1990.tb125144.x.

Abstract

An idiopathic, asymmetrical oligoarthritis affecting young adults is prevalent in the tropical regions of Africa, Asia and Melanesia. A serological study was undertaken in 23 consecutive patients with polyarthritis. Each patient was assigned two paired control subjects. A standardized history, physical examination and investigations were performed. Acute and convalescent sera were examined for evidence of recent infection. The presence of HLA-B27 was determined. Twelve (52%) of the 23 patients had more than one of the clinical features of a reactive arthritis. No serological evidence was found of acute infection with viruses (arboviruses, enteroviruses, mumps, rubella, adenoviruses, Epstein-Barr virus and hepatitis B), Chlamydia, Mycoplasma, Yersinia or syphilis. HLA-B27 was found in 14 (61%) of the 23 patients in contrast with in seven (17%) of the 41 control subjects (P less than 0.001). In two patients with HLA-B27, diagnostic titres of antibodies to Campylobacter jejuni-Campylobacter coli indicated recent infection. The presence of HLA-B27 antigen was significantly (P less than 0.05) associated with the presence of the clinical features of reactive arthritis. This study suggests that "tropical arthritis" commonly is a reactive arthritis that is associated with the presence of HLA-B27.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Arthritis / classification
  • Arthritis / complications
  • Arthritis / diagnosis
  • Arthritis / epidemiology
  • Arthritis / etiology*
  • Arthritis / immunology
  • Female
  • HLA-B27 Antigen / analysis
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Male
  • Middle Aged
  • Papua New Guinea / epidemiology
  • Prospective Studies
  • Recurrence
  • Time Factors
  • Tropical Climate*

Substances

  • HLA-B27 Antigen
  • Immunoglobulin G
  • Immunoglobulin M