Læknablaðið : fylgirit - 01.05.1978, Blaðsíða 111

Tor Reiten, M.D. Kjell O. Skavdal, M.D.1
and Bjarte G. Solheim, M.D.2
^Betanien Hospital, Department of Rheumatology,
Céntral Hospital of Telemark, 3700 Skien
2Tissue Typing Laboratory, National Hospital of
Norway, Oslo 1, Norway
The investigation has been supported by grants
from The Norwegian Council for Science and the
Humanities, The Norwegian Cancer Society and
Mr. Anders Jahre's Medical Research Fund.
Reprint requests should be sent to the Tissue
Typing Laboratory, National Hospital of Norway.
Abstract:
Fifty-two patients with established ankylosing
spondylitis and 48 patients with back pain not
fulfilling the criteria for ankylosing spondylitis
have been typed for HLA-B27. The frequency
of HLA-B27 was 9ð7o in patients with ankylosing
spondylitis compared to 11.04% among 788
healthy controls (p< 0.001). Among the patients
with back pain, the frequency of -B27 was only
10.4%. Thus also this material emphasizes the
value of HLA-B27 typing in patients suspected
of ankylosing spondylitis.
Introduction:
The original observation of the significantly
increased frequency of HIA-B27 in ankylosing
spondylitis (1,2) has resulted in a great interest
in the association between HLA antigens and
rheumatological diseases. In the present
investigation, a group of patients with ankylosing
spondylitis is compared with a group of patients
Table I
HLA-B27 and ankylosing spondylitis
No. investigated HLA-B27 pos. % of total
Mb.Bechterew 52 50 96.0
Dorsalgia 48 5 10.4
Controls 788 87 11.04
109
HLA-B27 IN ANKYLOSING
SPONDILYTIS
with back pain, not fulfilling the criteria for
ankylosing spondylitis.
Materials and methods:
All persons were unrelated and of Caucasoid
Norwegian origin.
The diagnosis, ankylosing spondylitis, was
defined by X-ray examination and/or clinical
symptoms as defined by Orgyzlo (3).
In the patient group with back pain not ful-
filling the criteria for ankylosing spondylitis,
three were excluded because of anamnestic
information of uveitis/irideocyclitis. The back
pain in the remaining 48 was of unclear origin,
with none of the patients fitting into a clear-cut
diagnosis.
Healthy controls were all unrelated persons
from different parts of Norway (no Lapps) and
consisted of blood donors and other normal,
healthy individuals, in addition to parents of
patients with uremia (4).
Tissue typing was performed with the micro-
cytotoxicity assay of Kissmeyer-Nielsen & Kjerbye
(5) with separation of the lymphocytes by flotation
on Ficoll-Isopaque (6). The investigation patients
were generally only tested with two different sera
reacting with HLA-B8 and two sera reactive with
HLA-B27 plus a multispesific anti-IILA control
serum. Only occasionally complete HLA typing
with sera recognizing 9 HLA-A, 19 HLA-B and
five HLA-C determinants was performed. The
controls, however, were typed with all available
sera.
Results and discussion:
Table I shows that in 52 patients with ankylosing
spondylitis, 50 had HLA-B27, which gives a fre-
quency of 967o (p< 0.001). In the group of patients
with dorsalgia, only 5/48 were positive for HLA-
B27, which gives an incidence of 10.4%; a value
which is strikingly similar to the 11.04% found
among 788 healthy controls. Thus, the frequency
of HLA-B27 is significantly increased only in the
patients with ankylosing spondylitis, which further
emphasizes the diagnostic value of establishing
whether a patient suspected of having ankylosing
spondylitis carries this antigen or not.