Document 0138
 DOCN  M9580138
 TI    The spondyloarthropathies.
 DT    9506
 AU    Richens J; McGill PE; Academic Department of Genitourinary Medicine,
       University College; London Medical School, UK.
 SO    Baillieres Clin Rheumatol. 1995 Feb;9(1):95-109. Unique Identifier :
       AIDSLINE MED/95246166
 AB    The spondyloarthropathies occur with variable frequency in the tropics.
       Ankylosing spondylitis, in particular, is thought to be rare in tropical
       Africa, reflecting a low frequency of the HLA B27 gene. However, in the
       Melanesian populations of Papua New Guinea where there is a relatively
       high frequency of HLA B27, ankylosing spondylosis is infrequent. These
       diverse observations may be related to variations in B27 sub-types.
       Reactive arthritis is a common and important form of acute arthritis in
       the tropics and in Papua New Guinea at least has a strong association
       with HLA B27. In Africa an increasing prevalence of reactive arthritis
       may be related to the spread of HIV infection. Extra-articular features
       such as balanitis and enthositis are helpful pointers to the diagnosis.
       Disseminated gonococcal infection and tuberculosis must always be
       considered and treatment offered if doubt exists. The mainstay of
       treatment of reactive arthritis is, as always, an anti-inflammatory
       drug, supplemented by hydrocortisone injections; docycline is available
       for chlamydia-triggered arthritis and chloroquine or dapsone for more
       chronic, unresponsive cases.
 DE    Arthritis, Psoriatic/*EPIDEMIOLOGY/IMMUNOLOGY  Arthritis,
       Reactive/COMPLICATIONS/DRUG THERAPY/*EPIDEMIOLOGY  Female  Human
       HLA-B27 Antigen  Male  Papua New Guinea/EPIDEMIOLOGY  Spondylitis,
       Ankylosing/*EPIDEMIOLOGY  JOURNAL ARTICLE

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