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HLA-B27 predicts a more chronic disease course in an 8-year followup cohort of patients with juvenile idiopathic arthritis.
J Rheumatol. 2013 May; 40(5):725-31.JR

Abstract

OBJECTIVE

We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA).

METHODS

We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible.

RESULTS

HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease.

CONCLUSION

In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease.

Authors+Show Affiliations

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. lillemor.berntson@kbh.uu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23547219

Citation

Berntson, Lillemor, et al. "HLA-B27 Predicts a More Chronic Disease Course in an 8-year Followup Cohort of Patients With Juvenile Idiopathic Arthritis." The Journal of Rheumatology, vol. 40, no. 5, 2013, pp. 725-31.
Berntson L, Nordal E, Aalto K, et al. HLA-B27 predicts a more chronic disease course in an 8-year followup cohort of patients with juvenile idiopathic arthritis. J Rheumatol. 2013;40(5):725-31.
Berntson, L., Nordal, E., Aalto, K., Peltoniemi, S., Herlin, T., Zak, M., Nielsen, S., & Rygg, M. (2013). HLA-B27 predicts a more chronic disease course in an 8-year followup cohort of patients with juvenile idiopathic arthritis. The Journal of Rheumatology, 40(5), 725-31. https://doi.org/10.3899/jrheum.121257
Berntson L, et al. HLA-B27 Predicts a More Chronic Disease Course in an 8-year Followup Cohort of Patients With Juvenile Idiopathic Arthritis. J Rheumatol. 2013;40(5):725-31. PubMed PMID: 23547219.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HLA-B27 predicts a more chronic disease course in an 8-year followup cohort of patients with juvenile idiopathic arthritis. AU - Berntson,Lillemor, AU - Nordal,Ellen, AU - Aalto,Kristiina, AU - Peltoniemi,Suvi, AU - Herlin,Troels, AU - Zak,Marek, AU - Nielsen,Susan, AU - Rygg,Marite, AU - ,, Y1 - 2013/04/01/ PY - 2013/4/3/entrez PY - 2013/4/3/pubmed PY - 2013/12/16/medline KW - CHILD KW - GENETICS KW - HLA-B27 KW - JOINTS KW - JUVENILE RHEUMATOID ARTHRITIS SP - 725 EP - 31 JF - The Journal of rheumatology JO - J Rheumatol VL - 40 IS - 5 N2 - OBJECTIVE: We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA). METHODS: We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible. RESULTS: HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease. CONCLUSION: In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/23547219/HLA_B27_predicts_a_more_chronic_disease_course_in_an_8_year_followup_cohort_of_patients_with_juvenile_idiopathic_arthritis_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=23547219 DB - PRIME DP - Unbound Medicine ER -