CAUSES OF CHRONIC POLYARTHRITIS IN LOME ( TOGO)

Medical records were reviewed retrospectively to determine the causes of chronic polyarthritis in patients attending a hospital outpatient c linic in Lome (Togo). Among 2812 patients seen over 44 months, 70 (2.5 %; 28 female, 42 male) had polyarthritis of at least three months' dur ation. Twenty-sig patients (17 female, 9 male), with a mean age of 30 years at disease onset, had isolated, nondestructive polyarthritis mai nly involving the distal appendicular joints and responsible for short -lived flares usually adequately controlled by nonsteroidal antiinflam matory agents alone; antinuclear antibodies were looked for in 16 of t hese patients with positive results in eight. The favorable outcome an d negative tests for rheumatoid factors differentiated this condition from rheumatoid arthritis. None of the 26 patients had systemic manife stations possibly suggestive of connective tissue disease. Diagnoses i n the 44 remaining patients included gout (n=15), spondyloarthropathy (n=12), rheumatoid arthritis (n=12), juvenile chronic arthritis (n=2) and human immunodeficiency virus infection (n=3). These data confirm t hat rheumatoid arthritis is infrequent in West Africa. The leading cau se of chronic-polyarthritis in Lome may be mild isolated nondestructiv e polyarthritis reminiscent of adult-onset oligoarthritis with antinuc lear antibodies. Long-term follow-up and immunological evaluation of p atients with this condition can be expected to provide valuable pathog enic and nosologic information.