HLA-B27 predicts a more extended disease with increasing age at onset in boys with juvenile idiopathic arthritis
2008 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 35, no 10, 2055-2061 p.Article in journal (Refereed) Published
Objective. Juvenile idiopathic arthritis (JIA) is a heterogeneous condition with very few clinical and laboratory signs that can help predict the course and severity of the disease in the individual patient. The cell-surface antigen HLA-1327 is well known to be associated with spondyloarthropathies, reactive arthritis, and enthesitis. HLA-1327 plays all important role in the classification of JIA, since evidence of sacroiliitis most often evolves after years of arthritis in other Joints. We investigated the associations of HLA-B27 and the clinical manifestations of JIA using a method as close to a poplulation-based study as possible. Methods. We studied,in incidence-based cohort of 305 patients collected prospectively ill 3 Nordic countries (Sweden, Norway, Denmark). Clinical and serological data of the first 3),cars of the disease were collected. Results. HLA-B27 was found to be positive in 25.5% of the Patients, and We found a higher proportion of HLA-B27-positive boys with older age at disease onset (p = 0.034). Regression analysis showed a correlation of 0.7 in the HLA-B27-positive boys. pointing to a higher risk of more Joint involvement with older a,,e at disease onset. By Fisher's exact test, involvement of small joints in the lower extremities was associated with HLA-B27 in boys (p = 0.011) but not in girls (p = 0.687). HLA-B27 was associated with inflammatory back pain in both sexes (1) = 0.041 in boys, p 0.042 in girls), but with enthesitis only in boys (p < 0.001 in boys. p = 0.708 in girls). Conclusion. HLA-B27 is of increasing importance with older age at disease onset in boys with JIA, predicting more active joints within the first 3 years of disease, and also involving small joints in the lower extremity, to a greater degree than in HLA-B27-negative boys. During the first 3 years of disease the occurrence of HLA-B27 is associated with inflammatory back pain ill both sexes, bill with enthesitis only in boys. Our data present new challenges for file ILAR classification of JIA.
Place, publisher, year, edition, pages
2008. Vol. 35, no 10, 2055-2061 p.
juvenile rheumatoid arthritis, genetics, HLA-B27, child, joints
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-107878ISI: 000259908900024PubMedID: 18785306OAI: oai:DiVA.org:uu-107878DiVA: diva2:233372