HLA antigens and gold toxicity in American blacks with rheumatoid arthritis

Abstract

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.

Epidemiologic and immunogenetic aspects of polymyalgia rheumatica and giant cell arteritis in northern Italy

“…Cid et a1 (18) confirmed that, in Spanish patients with biops y-proven GCA, DR4 is mainly associated with PMR. The incidence of GCA and/or PMR has been shown to be low in blacks (26), paralleling the low frequency of HLA-DR4 observed in this population (27). Interestingly, there is a corresponding low incidence of PMR and GCA coupled with a low incidence of DR4 in the general population (range 12-14% [19,20]) in northern Italy.…”

Radiographic severity of Rheumatoid Arthritis in African Americans: Results from a multicenter observational study

“…RA progression has been extensively examined in many ethnic groups, with the exception of the African American population. This population, often underrepresented in both observational studies and randomized clinical trials, needs to be evaluated in order to understand the disease course and the potential presence of ethnic‐specific risk factors (6–9). To date, there have been few descriptions of the clinical features of RA in this racial/ethnic group.…”

Association of IL4Rsingle-nucleotide polymorphisms with rheumatoid nodules in African Americans with rheumatoid arthritis

“…This study may improve our understanding of the disease course in these patients and possibly help to identify the presence of ethnic-specific risk factors [19-22]. …”