Clinical and radiological studies in rheumatoid arthritis and its seronegative variants and their relation to HLA antigens

ABSTRACT

One hundred patients with rheumatoid arthritis [RA] or its variants and 100 age and sex matched controls were typed for HLA antigens, HLA-DR4 was found significantly more frequent in RA patients as a whole, 55% compared to 2% for controls. DR4 positive patients exhibited the more severe and aggressive form of the disease evidenced by a longer duration of stiffness, early appearance of radiological changes and severe bony destruction and higher articular index compared to those with other antigens. HLA-DR2 and DR7 were found to be negatively correlated with RA patients as they were detected in lower frequency in RA pts. Compared to controls especially in those with peripheral joint involvement i.e. they are protective antigens. A positive family history of rheumatoid disease was detected in 80% of DR4 the + ve oners. HLA-DR3 was found at a higher frequency among patients with nodules and correlated with high titres of rheumatoid factor, higher C-reactive protein levels and positive antinuclear factor. In seronegative RA groups HLP-DR5 was significantly higher compared to controls while HLA-DR4 was more significantly more frequent in seropositive juvenile arthritis compared to controls HLA-B27 were more frequent in those with ankylosing spondylitis than the controls. The other antigens of A,B and C loci showed no significant correlations