‘Navajo Arthritis’ reconsidered

Abstract

"Navajo arthritis" was described in 1971 as an acute, self-limited, asymmetric polyarthritis of unknown etiology seen in Navajo Indian patients. This description was before published accounts relating HLA-B27 to certain seronegative arthropathies. Review of 92 cases of arthritis seen between 1977 through 1979 in adult Navajo Indians revealed 16 cases of complete Reiter's syndrome, 6 cases of incomplete Reiter's syndrome, and 7 cases of ankylosing spondylitis. The phenotype frequency of HLA-B27 in this Navajo population is 36% and, of the Reiter's syndrome and ankylosing spondylitis patients tested, 85% were found to be HLA-B27 positive. We suggest that "Navajo arthritis" may not be a unique form of arthritis affecting only the Navajo, but a variant of either Reiter's syndrome or ankylosing spondylitis.In 1971, Muggia, Bennahum, and Williams described 21 cases of an acute, self-limited, asymmetric polyarthritis of unknown etiology in Navajo patients (I). The entity was termed "Navajo arthritis" and felt to be a distinct syndrome. Our recent clinical experience

Systematic review of rheumatic disease phenotypes and outcomes in the Indigenous populations of Canada, the USA, Australia and New Zealand

“…Thirteen studies characterizing spondyloarthropathies in Indigenous populations were identified; one of these was on ankylosing spondylitis in three First Nations populations in Canada (Bella Bella, Bella Coola and Haida) and an American Indian population (Pima) in the USA [62], one was from a Canadian Inuit population with spondyloarthritis [20], two from Canadian First Nations populations with ankylosing spondylitis (Haida) [63] and spondyloarthritis (Nuu-Chah-Nulth) [42], two were from the Navajo population with ankylosing spondylitis and reactive arthritis in the USA [64, 65], and seven included analyses on a cohort of Alaskan Native patients with conditions including ankylosing spondylitis, reactive arthritis, psoriatic arthritis and undifferentiated spondyloarthritis [38, 66–71]. …”

“…In the Navajo population, 80% of ankylosing spondylitis patients were HLA-B27 positive and 43% had knee involvement [64]. Seventy two percent with reactive arthritis had the characteristic triad of arthritis, conjunctivitis and urethritis, 88% were HLA-B27 positive, 53% had radiographic sacroiliitis, and 33% had uveitis or iritis [65].…”