Document Detail


HLA-B27 predicts a more extended disease with increasing age at onset in boys with juvenile idiopathic arthritis.
MedLine Citation:
PMID:  18785306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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-B27 is well known to be associated with spondyloarthropathies, reactive arthritis, and enthesitis. HLA-B27 plays an 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 population-based study as possible. METHODS: We studied an incidence-based cohort of 305 patients collected prospectively in 3 Nordic countries (Sweden, Norway, Denmark). Clinical and serological data of the first 3 years 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 age 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 (p=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 in both sexes, but with enthesitis only in boys. Our data present new challenges for the ILAR classification of JIA.
Authors:
Lillemor Berntson; Michael Damgård; Boel Andersson-Gäre; Troels Herlin; Susan Nielsen; Ellen Nordal; Marite Rygg; Marek Zak; Anders Fasth;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-09-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-09     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  2055-61     Citation Subset:  IM    
Affiliation:
Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden. lillemor.berntson@telia.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age of Onset
Arthritis, Juvenile Rheumatoid / genetics*
Child
Child, Preschool
Denmark
Disease Progression
Female
Genetic Predisposition to Disease / genetics*
HLA-B27 Antigen / genetics*
Humans
Longitudinal Studies
Male
Norway
Sex Factors
Sweden
Chemical
Reg. No./Substance:
0/HLA-B27 Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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