Reactive arthritis in patients attending an urban sexually transmitted diseases clinic.
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.
Rich
E
E
University of Alabama at Birmingham, USA.
Hook
E W
EW
Alarcón
G S
GS
Moreland
L W
LW
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
D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins