CREG antigens differentially influence expression of extraarticular manifestations in whites and blacks with rheumatoid arthritis

An increase in the frequency of DR3 in rheumatoid arthritis (RA) patients exhibiting toxic reactions to chrysotherapy has been reported in several studies of white patients. This study was designed to compare DR antigen frequencies in local white RA patients undergoing chrysotherapy with their response to treatment. The results from our sample of RA patients (n = 148) confirm the fact that there is increased frequency of DR3 in patients who develop toxic reactions to gold therapy, as reported in other studies of white patients. The DR3 increase was attributable to those gold‐treated patients who developed proteinuria, and was not observed in patients who developed skin toxicity. Interestingly, the associations were not as strong as those found in other reports. Only 21.1% of the patients with DR3 manifested toxic reactions overall, with only one‐third of the patients with proteinuria being DR3 positive. There was also an association of toxicity, albeit not significant, with a decreased frequency of DR2, which is consistent with the suggestion that this phenotype may protect against adverse reactions to gold treatment. These results suggest that while DR3 is significantly associated with adverse response to gold treatment, the relationship is not as strong as that previously reported. Explanation of these differences remains to be elucidated.

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Dr Antigens and Gold Toxicity in white rheumatoid arthritis patients

Barger

Acton

Koopman

et al. 1984

Arthritis & Rheumatism

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HLA antigens and gold toxicity in American blacks with rheumatoid arthritis

et al. 1986

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An increase in the frequency of DR3 in rheumatoid arthritis (RA) patients exhibiting toxic reactions to gold salt (GS) therapy has been observed in several studies of Caucasoid patients. Likewise, the association of B35 with gold-induced mucocutaneous reactions has also been reported in Caucasoid RA patients. Similar studies in other ethnic groups have not been previously documented. The present study was performed in American black RA patients receiving GS to determine if there were similar HLA associations with toxic reactions as those reported in Caucasoids. Eight-two seropositive and 18 seronegative American black RA patients were studied. Forty-one of the seropositive (50.0%) and six of the seronegative (33.3%) developed a toxic manifestation. No significant differences in the frequency distribution of HLA-B8, HLA-B35, DR, or DQw antigens were observed between the patients who had a toxic reaction and those who did not in either the seropositive or the seronegative RA patients. In particular, DR3 was not increased in patients with renal toxicity and B35 was not increased in patients with mucocutaneous reaction. Our study demonstrates that American black RA patients exhibiting GS toxicity do not have the same HLA associations as Caucasoids. The possibility that other genetic factor(s) may account for the occurrence of gold salt toxicity in American blacks requires further investigation.

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Rheumatoid arthritis in African Colombians from Quibdo

Anaya

Correa

Mantilla

et al. 2001

Seminars in Arthritis and Rheumatism

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CREG antigens differentially influence expression of extraarticular manifestations in whites and blacks with rheumatoid arthritis

Cited by 4 publications

References 35 publications

Dr Antigens and Gold Toxicity in white rheumatoid arthritis patients

Dr Antigens and Gold Toxicity in white rheumatoid arthritis patients

HLA antigens and gold toxicity in American blacks with rheumatoid arthritis

Rheumatoid arthritis in African Colombians from Quibdo

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