HLA-B27-associated seronegative enthesopathy and arthropathy in a black child

A 16-year-old black child with seronegative enthesopathy and arthropathy, who had the HLA-B27 antigen but no clinical or radiographic evidence of sacro-iliitis, is described. The patient did not fulfil the criteria for any of the seronegative spondylo-arthropathies. He was assessed as having the subtype of pauci-articular juvenile chronic arthritis, which occurs in older boys and is associated with HLA-B27, and he also had features of the seronegative enthesopathy and arthropathy syndrome, which has been reported in children. The HLA-B27-associated diseases, such as ankylosing spondylitis and Reiter's syndrome, are uncommon in black adults and there is very little data on their occurrence in black children. Suspicion of this entity in children will permit an accurate diagnosis and help to distinguish these children from those with other childhood rheumatic disorders.