HLA-B27 in French Patients with Rheumatoid Arthritis

Saraux, Alain; Guedes, C.; Allain, J.; Valls, I.; Baron, D.; Youinou, Pierre; Goff, P. Le

doi:10.3109/03009749709105315

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…In fact, this is the unique association with HLA-B27 that has been replicated in different RA studies. However, two previous studies did not found differences in the sacroiliac joints between HLA-B27 positive and negative patients with RA [47], [48]. These findings should motivate new studies directed to the analysis of low back pain and to the identification of sacroiliitis.…”

Section: Discussionmentioning

confidence: 82%

Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

et al. 2013

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IntroductionHLA-B27 has a modifier effect on the phenotype of multiple diseases, both associated and non-associated with it. Among these effects, an increased frequency of clinical enthesitis in patients with Rheumatoid Arthritis (RA) has been reported but never explored again. We aimed to replicate this study with a sensitive and quantitative assessment of enthesitis by using standardized ultrasonography (US).MethodsThe Madrid Sonography Enthesitis Index (MASEI) was applied to the US assessment of 41 HLA-B27 positive and 41 matched HLA-B27 negative patients with longstanding RA. Clinical characteristics including explorations aimed to evaluate spondyloarthrtitis and laboratory tests were also done.ResultsA significant degree of abnormalities in the entheses of the patients with RA were found, but the MASEI values, and each of its components including the Doppler signal, were similar in HLA-B27 positive and negative patients. An increase of the MASEI scores with age was identified. Differences in two clinical features were found: a lower prevalence of rheumatoid factor and a more common story of low back pain in the HLA-B27 positive patients than in the negative. The latter was accompanied by radiographic sacroiliitis in two HLA-B27 positive patients. No other differences were detected.ConclusionWe have found that HLA-B27 positive patients with RA do not have more enthesitis as assessed with US than the patients lacking this HLA allele. However, HLA-B27 could be shaping the RA phenotype towards RF seronegativity and axial involvement.

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Section: Discussionmentioning

confidence: 82%

Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

et al. 2013

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“…For other investigations for diagnosis of RA, we found no literature that directly answered these topics. We therefore extrapolated data from related articles showing that complete blood count (CBC), antinuclear antibodies (ANA), human leukocyte antigen (HLA) B27, radiographs of sacroilliac joint, uric acid, human immunodeficiency virus (HIV), hepatitis B (HBV) and C virus (HCV), thyroid function tests, and synovial fluid analysis are non‐specific and cannot be used alone to exclude other diseases.…”

Section: Recommendationsmentioning

confidence: 99%

Evidence‐based recommendations for the diagnosis and management of rheumatoid arthritis for non‐rheumatologists: Integrating systematic literature research and expert opinion of the Thai Rheumatism Association

et al. 2016

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Association of HLA alleles and clinical features in patients with synovitis of recent onset

El‐Gabalawy

Goldbach‐Mansky

Smith

et al. 1999

Arthritis & Rheumatism

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Objective. To determine how HLA alleles are associated with the clinical disease patterns of patients with synovitis of recent onset. Methods. The HLA alleles A, B, C, DR1, and DQ1 were determined in a cohort of 211 patients (mean age 42 years, 64% female, 79% white) with recent-onset synovitis in 1 or more peripheral joints. At a mean disease duration of 33 weeks, 98 patients (46%) met the American College of Rheumatology (ACR) criteria for rheumatoid arthritis (RA), 38 (18%) met the European Spondylarthropathy Study Group criteria for spondylarthropathy (SpA), and 75 (36%) were classified as having undifferentiated arthropathy (UA). Controls were racially matched healthy individuals (n 244). Results. Shared epitope (SE) alleles were significantly more common in rheumatoid factor-positive (RF) patients fulfilling the ACR RA criteria than in other patients with early arthritis (65% versus 35%; P < 0.001). In addition, the RA patients had by far the highest frequency of radiographic erosions (52% and 39% in RF and RF RA, respectively, versus 3% and 9% in SpA and UA patients, respectively; P < 0.0001). The presence of SE alleles was a particularly strong predictor of early erosions in the RF RA patients (odds ratio [OR] 6.8, 95% confidence interval [95% CI] 1.2-45). The presence of 2 SE alleles or an associated DQ1*0301 (DQ7) or DQ1*0302 (DQ8) allele appeared to modestly increase the risk of early erosions, although these DQ alleles were in strong linkage disequili-brium with DR1*0401, both in the patient and in the control populations. B27 was linked with the presence of SE alleles in the patients, including those patients fulfilling the RA criteria, but not in the controls (12% versus 3%; P < 0.001). Enthesitis was present in 23 (11%) of 211 patients, was highly associated with B27 (OR 4.2, 95% CI 1.5-11.5), and surprisingly, was not a feature specific only to the SpA group. The B8-DR3 haplotype was significantly increased in the patient subgroups compared with controls (17% versus 7%; P < 0.01), although the clinical significance of this association is unclear. Conclusion. This study of HLA associations in a diverse cohort of early synovitis patients emphasizes the complex degree of genetic interaction between alleles at several major histocompatibility complex loci, which regulates clinical phenotypes. In particular, SE and B27, while predisposing patients to characteristic clinical syndromes, had an unexpected degree of association in this cohort, perhaps explaining the overlap in clinical features in many patients. Synovitis in 1 or more peripheral joints is the presenting feature of several chronic inflammatory ar-thropathies. The clinical spectrum of rheumatoid arthritis (RA) and the seronegative spondylarthropathies (SpA), which are disorders presumably having distinct pathogenetic mechanisms, can be difficult to differentiate early in the disease course. Moreover, a large proportion of patients with synovitis of recent onset lack specific diagnostic features and are classified as having undifferentiated ...

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HLA-B27 in French Patients with Rheumatoid Arthritis

Cited by 5 publications

References 14 publications

Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

Ultrasonographic Assessment of Enthesitis in HLA-B27 Positive Patients with Rheumatoid Arthritis, a Matched Case-Only Study

Evidence‐based recommendations for the diagnosis and management of rheumatoid arthritis for non‐rheumatologists: Integrating systematic literature research and expert opinion of the Thai Rheumatism Association

Association of HLA alleles and clinical features in patients with synovitis of recent onset

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