[Etiologies of chronic polyarthritis in Lomé (Togo)]

Medical records were reviewed retrospectively to determine the causes of chronic polyarthritis in patients attending a hospital outpatient clinic in Lomé (Togo). Among 2812 patients seen over 44 months, 70 (2.5%; 28 female, 42 male) had polyarthritis of at least three months' duration. Twenty-six patients (17 female, 9 male), with a mean age of 30 years at disease onset, had isolated, nondestructive polyarthritis mainly involving the distal appendicular joints and responsible for short-lived flares usually adequately controlled by nonsteroidal antiinflammatory agents alone; antinuclear antibodies were looked for in 16 of these patients with positive results in eight. The favorable outcome and negative tests for rheumatoid factors differentiated this condition from rheumatoid arthritis. None of the 26 patients had systemic manifestations possibly suggestive of connective tissue disease. Diagnoses in 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 that rheumatoid arthritis is infrequent in West Africa. The leading cause of chronic polyarthritis in Lomé may be mild isolated nondestructive polyarthritis reminiscent of adult-onset oligoarthritis with antinuclear antibodies. Long-term follow-up and immunological evaluation of patients with this condition can be expected to provide valuable pathogenic and nosologic information.