HLA B27: A prognostic factor in juvenile chronic arthritis

Abstract

This study was performed to assess the frequency of HLA B27 in patients with juvenile chronic arthritis (JCA) of varying severity and outcome by studying three patient categories: those in whom cytostatic treatment with azathioprine had been started, those with secondary amyloidosis, and those with arthroplasty of the knee or hip joints. In the first category the frequency of the HLA B27 allele was compared between those who had attained remission and those who had not. In the second and third categories the rate at which amyloidosis developed and the timing for the need of arthroplasty, were compared for HLA B27-positive and -negative patients. A control group consisted of 37 patients with uncomplicated seronegative polyarthritis. Ten of the 37 patients in the control group (27%) were HLA B27 positive as opposed to 84 out of 190 (44%) in the three study groups. Of the 101 patients treated with azathioprine, two out of 15 in remission were HLA B27 positive, whereas as many as 41 out of 86 with still active disease were HLA B27 positive (p = 0.013). Of the secondary amyloidosis patients, 29 out of 51 carried HLA B27. The HLA B27-positive patients contracted amyloidosis on average 5.9 (median 6.7) years earlier than the HLA B27-negative patients (p = 0.038). Of the arthroplasty patients, 39 out of 91 carried HLA B27. The HLA B27-positive patients underwent arthroplasty on average 2.9 (median 3.5) years earlier than the HLA B27-negative patients (p = 0.050). We conclude that HLA B27-positive cases are accumulated among the most severe cases of JCA.

A retrospective study on 158 Thai patients with juvenile idiopathic arthritis followed in a single center over a 15‐year period

“…This finding is in agreement with Berntson et al . Other studies have also shown HLA‐B27 to be associated with a more destructive disease and difficulty in achieving remission when compared with other categories . However, to the best of our knowledge, no study has reported HLA‐B27 as a predictor for biologic treatment in ERA patients.…”

Radiologic features in juvenile idiopathic arthritis: A first step in the development of a standardized assessment method

“…IgM‐RF–positive patients with JIA are known to have a disease course similar to that of adult RA, and HLA–B27–positive patients (boys with disease onset beyond 8 years of age and with enthesitis and arthritis) are thought to have a disease course similar to that in adults with ankylosing spondylitis. One other study has also indicated that HLA–B27 positivity in JIA patients relates to a more severe course of JIA (39).…”

Uveitis in young adults with juvenile idiopathic arthritis: a clinical evaluation of 123 patients

“…4 The overall frequency of HLA B27 in the Finnish population is as high as 14.5% and among JIA patients it is about 30%. 5 Among patients with asymptomatic uveitis, arthritis began earlier and ANA positivity was more common than among those without uveitis. Also, positive HLA B27 was found more often in these patients.…”

“…The outcome of JIA has interested many researchers during the past three decades. [5][6][7][8][9] However, only limited information is available on the prognosis of uveitis in JIA patients reaching adulthood. In a recent Danish 25 year retrospective study, uveitis had occurred in 10 of 65 adult patients with juvenile arthritis; the eye inflammation was persistent or chronic in three of these.…”