Prevalence, Risk Factors, and Expression of Human Leukocyte Antigen-DRB1 in Juvenile Idiopathic Arthritis-associated Uveitis

ABSTRACT

OBJECTIVE: This study investigated the prevalence and risk factors of juvenile idiopathic arthritis (JIA)-associated uveitis (JIA-U) in a pediatric tertiary center in Korea. In addition, this study examined whether a specific HLA-DRB1 allele could be a predictive risk factor of uveitis in JIA. METHODS: The pediatric rheumatology and ophthalmology medical records for JIA between March 2006 and March 2016 were analyzed retrospectively. A total of 233 were enrolled in this study. RESULTS: Of 233 patients, 31 developed uveitis (13.3%) 14 oligoarticular, three polyarticular, six systemic, seven enthesitis-related, and one undifferentiated-type JIA. In oligoarticular JIA, 26.4% developed uveitis. The percentage of females with JIA-U was 54.8%, and the median age of the onset of JIA was 7.02 years in JIA-U. Antinuclear antibody (ANA) positivity in oligoarticular JIA-U was 57.1%. Of the 31 JIA-U cases, 26 (83.9%) were clinically asymptomatic when diagnosed. The allele frequency of HLA-DRB1*09 of the total JIA-U was higher than that of JIA without uveitis. HLA-DRB1*09 and HLA-DRB1*12 were higher in oligoarticular JIA-U than in JIA without uveitis. CONCLUSION: Korean JIA-U has different features from JIA-U in Western countries. The sex ratio and age of JIA onset showed no significant differences in Korean JIA-U. The ANA positivity was more common in JIA-U than in JIA without uveitis only in oligoarticular type JIA. These differences might be due to genetic factors, particularly HLA-DRB1. These results suggest HLA-DRB1*09 and HLA-DRB1*12 in oligoarticular JIA to be risk factors for JIA-U in Korea. This is the first study to analyze the association between HLA-DRB1 and JIA-U in Korea.