HLA and Juvenile Chronic Polyarthritis

Abstract

HLA antigens have been identified in patients with juvenile chronic polyarthritis (J.C.P.) (n = 35). In J.C.P. the incidence of antigen B27 (57%) was found to be higher than in a normal population (n = 1,000). On recent evaluation of the clinical status, serology and x‐rays, the patients with juvenile chronic polyarthritis who have been followed up for many years, could be subdivided into four groups: Group 1: J.C.P. evolving to ankylosing spondylitis (n = 3); Group 2: J.C.P. with sacroiliitis (n = 17); Group 3: J.C.P. without sacroiliitis (n = 9); Group 4: juvenile rheumatoid arthritis characterised by a positive serology (n = 6). Groups 1 and 2 were characterised by a high incidence of antigen B27 (19/20). Only one subject of groups 3 and 4 had antigen B27. Sex distribution in groups 1 and 2 was found to be similar to that found in ankylosing spondylitis in adults and sex distribution in groups 3 and 4 was found to be similar to that found in rheumatoid arthritis in adults. It is concluded that if B27 positives develop juvenile chronic polyarthritis they have a high risk of developing sacroiliitis and acute uveitis. The authors propose to give the name Still's disease to the total group of children presenting initial symptoms corresponding to the criteria of Ansell & By waters (1959). Follow‐up of the cases permitted their further classification as juvenile ankylosing spondylitis, as juvenile chronic polyarthritis with or without sacroiliitis or as juvenile rheumatoid arthritis.

Frequency of HLA‐Dw3 in Juvenile Rheumatoid Arthritis

“…I t remains possible, however, that some of our patients with HLA-B27 will show signs of these diseases with time, particularly because of the male bias. This latter possibility would seem likely, based on data of other series of HLA frequency in JRA (Gibson et al 1975, Macurova et al 1976, Schaller et al 1976, Veys et al 1976). However, a major advantage of our study is the fact that it is a prospective analysis, i.e.…”