[Reflections on ankylosing spondylitis in Black Africa. Apropos of a juvenile-onset case]

From the starting point of two cases of ankylosing spondylitis, one of which began in youth, observed in Abidjan, Ivory Coast, a review of the literature concerning the major cases amongst africans is carried out. This disease is unusual in tropical Africa: about thirty published cases, of varied origin. This low incidence of ankylosing spondylitis is correlated to the rarity of the HLA B27 group and of seronegative spondylitic joint diseases in general amongst the black population of Africa. Whereas the high incidence of forms with juvenile onset in North Africa suggests some connection with undetected Reiter's disease, the infrequency of this form of onset of the disease in sub-Saharan Africa and the lack of bacteriologic evidence make it impossible to reach any such conclusions.