HLA DRB1, DMA, and DMB gene polymorphisms in rheumatoid arthritis.

OBJECTIVE: To study the influence of DMA and DMB genes on susceptibility to Rheumatoid Arthritis (RA). METHODS: HLA-DRB1, DMA and DMB polymorphisms were defined by PCR SSOP in 203 European Mediterranean RA patients and 181 unrelated healthy controls. RESULTS: No significant difference in the phenotype frequencies of DMA and DMB alleles was observed between patients and controls. We found decreased frequencies of DMA*0102 and DMB*0104 in patients but this did not reach significance. These decreased frequencies could be due to a positive linkage disequilibrium with DRB1*0701, an allele which is underrepresented in RA patients. In stratified analysis with RA susceptibility Epitope positive (SE) DRB1 alleles, there was no significant difference in DMA and DMB phenotype frequencies between SE/SE, SE/X, and X/X patients versus controls. Among SE/X subjects, no significant difference in DM distribution frequencies was observed in DRB1*0101/X, 0102/X, 0401/X, 0404/X and 0405/X groups. CONCLUSION: DMA and DMB polymorphism does not seem to influence susceptibility to develop RA. Differences in DMA phenotype frequencies between patients and controls are secondary to linkage disequilibrium with DRB1 alleles.

Iliopsoas bursopathies. A review of twelve cases.

Synovial cysts are far less common at the hip than at the knee and usually occur in patients whose hip cavity communicates with the iliopsoas bursa. We report 12 cases of enlargement of the iliopsoas bursa, nine men and three women, with a mean age of 48 years. The six patients with septic bursitis had severe symptoms similar to those seen in septic arthritis of the hip. Chronic pain with or without a palpable inguinal swelling was the main symptom in the six remaining patients, some of whom had compression of neighboring structures making the diagnosis more difficult. Ultrasonography is the best first-line investigation in patients with an inguinal swelling. Computed arthrotomography with examination of the synovial fluid or magnetic resonance imaging should be performed as a confirmatory diagnostic test. Our series provides evidence of the efficacy of appropriate antimicrobial therapy in septic cases and of corticosteroid injections into the bursa or hip cavity in nonseptic cases.

HLA-DRB1 alleles associated with rheumatoid arthritis in southern France. Absence of extraarticular disease despite expression of the shared epitope.

OBJECTIVE: Extraarticular rheumatoid arthritis (RA) is almost unknown in Marseille in southern France. We investigated whether this was due to rare expression of the HLA-DRB1 shared epitope. METHODS: HLA-DRB1 alleles were characterized in 73 patients with RA and 108 controls by polymerase chain reaction amplification and oligonucleotide hybridization. RESULTS: In patients with RA, 76% expressed the shared epitope (46% DR1, 45% DR4). Four HLA-DRB1 alleles were positively associated with disease: DRB1*0101, DRB1*0401, DRB1*0404, DRB1*0405. Patients with double dose shared epitope had the most severe articular damage, but no extraarticular disease. CONCLUSION: In Marseille, 76% of patients with RA are shared epitope positive. Still, most do not develop extraarticular RA. This may be caused by the low frequency of HLA-DRB1*0401 in this population.

[Sports activity and body composition. Study by whole body osteodensitometry of 269 men between 17 and 21 years of age]. / Activité sportive et composition corporelle. Etude par ostéodensitométrie "corps entier" de 269 hommes de 17 à 21 ans.

Two hundred and sixty one men aged between 17 and 21 were questioned concerning their sports activities and underwent "whole body" osteodensitometry. Values found in terms of bone density rose harmoniously and proportionally from the ages of 17 to 21. Studied in terms of sports activities claimed, figures were higher in athletes and this essentially concerning the lower limbs and pelvis. These data contrast a "growth" effect with a "physical activity" effect, the first being of a systemic nature involving total bone mass and the second of a locoregional nature concerning only those bone segments involved in a particular activity. Our study failed to reveal any arguments in favour of spinal bone steal to the advantage of the lower limbs in athletes. The authors feel that "whole body" osteodensitometry by simultaneous and prospective study of bone segments involved or not involved in exercise should enable a distinction to be drawn between the systemic and locoregional effects of physical activity and thus, in the context of primary prevention, to define the optimal calcium intake and physical activity leading to acquisition of maximum bone capital and to maintain it to the best possible extent.