title: Reactive arthritis in patients attending an urban sexually transmitted diseases clinic.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Alabama at Birmingham, USA.
authors.forename: E
authors.initials: E
authors.lastname: Rich
authors.forename: E W
authors.initials: EW
authors.lastname: Hook
authors.forename: G S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: L W
authors.initials: LW
authors.lastname: Moreland
mesh_terms: D000293:Adolescent; D000328:Adult; D000407:Alabama / Q000453:epidemiology; D000554:Ambulatory Care Facilities; D016918:Arthritis, Reactive / Q000150:complications / Q000453:epidemiology*; D002690:Chlamydia Infections / Q000150:complications; D002692:Chlamydia trachomatis; D005260:Female; D006069:Gonorrhea / Q000150:complications; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D011446:Prospective Studies; D012749:Sexually Transmitted Diseases / Q000150:complications*; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins