ABSTRACT
There has been an association between HLA-B27 and cardiovascular affection. Furthermore, a significantly increased prevalence of HLA-B27 was found in men with pacemakers who had no clinical or radiological signs of HLA-B27 associated disease. This study was planned to obtain more insight into the association between HLA-B27 and high grade AV block [HG-AVB] and sick sinus syndrome [SSS], and the possible role of HLA-B27 in causing this block. HLA tissue typing was preformed on 200 normal Egyptians [control] and 75 Egyptian pts who had permanent pacemakers implanted for HG-AVB and SSS who had no clinical or radiological signs of HLA-B27 associated disease. The pacemaker pts were classified into 3 groups according to the aetiology of AVB and SSS, group 1 included 5 pts with acquired HG-AVB, group II included 10 pts with congenital complete heart block and group III included 60 pts with idiopathic HG-AVB or SSS. HLA-B27 was present in 5/200 [2.5%] normal healthy Egyptians, in 6/60 [10%] pts with idiopathic HG-AVB and SSS [group III]. However, HLA-B27 was negative in both groups I and II. There was a statistically significant higher prevalence of HLA-B27 in pts with idiopathic HG-AVB/SSS than in both normal Egyptians and pts with acquired or congenital AVB [p < 0.05]. HLA-B27 might have a role in the aetiology of idiopathic AVB however, further research is needed to obtain more insight into its role and the role of other factors in idiopathic AVB