Læknablaðið : fylgirit - 01.05.1978, Page 113

E. Zachariae
Dept. of Rheumatology and Physical Medicine,
F. Kissmeyer
Tissue Typing Laboratory
Aarhus Kommunehospital, Denmark
A number of reports on tissue typing of patients
with juvenile chronic polyarthritis have been
published. The results support the concept, that
this disease may have a different course in
patients with a different genetic background. I
would like to present the results of tissue typing
of 53 patients with juvenile chronic polyarthritis.
The series include all patients with juvenile
chronic polyarthritis attending the clinic of
rheumatology and physical medicine at the Aarhus
municipality hospital in 1971-75. They all
fulfilled the criteria for juvenile chronic poly-
arthritis proposed by Ansell and Bywaters in 1959.
The tissue typing was performed at the tissue
typing laboratory, Aarhus municipality hospital.
12 of our 53 patients, (23f7o) carried the HLA
antigen B27, compared to S7o in 562 healthy
controls. (p=0.0035). 39 were girls, 14 were
boys. B27 was comparatively more frequent in
boys, it was present in 7 girls and 5 boys.
(Fig. I)
Fig. H shows the age at onset of the disease.
The patients in the B27 positive group showed
no tendency to late mean age at onset as it has
been shown by other authors^ (Hall et al. 1975).
Our mean age at onset for B27 positives was
5.2, for negatives 5.9. 3 patients had a very
HLA ANTIGENS IN JUVENILE
CHRONIC POLYARTHRITIS
low age at onset, under 1 year, one of them
was B27 positive.
None of our patients had ankylosing spondylitis.
Sacroiliitis was found in 6 patients, 3 boys and
3 girls, 2 in each group had the B27 antigen.
In 3 of these patients there was a late age at
onset, 13-15 years. 6 of our 53 patients had
uveitis. One boy and one girl lacked the 27
antigen, and their uveitis had a chronic course.
The other 4 had acute recurrent uveitis. 4
patients had a positive sheep cell test. They
were all girls with symmetrical joint involvement,
3 had a late onset of the disease, none of them
had the B27 antigen. (Fig. HI).
Fig. IV shows the distribution between pauci-
articular and polyarticular disease. Although
only 3 boys with pauciarticular disease wereB27
positive, this was a high percentage of the boys
with this type of disease. The girls with pauci-
articular disease did not show this prevalence.
Our findings widely agree with those of other
authors, especially those of the Taplow group.
They found a frequency of B27 of 29%, we found
237». Also our results support the coneept that
juvenile chronic polyarthritis to a certain degree
can be divided into subgroups. About 1/4 of the
patients carry the antigen B27. In this group
there is a comparatively high frequency of
sacroiliitis, which in some patients may develop
into ankylosing spondylitis. Recurrent anterior
uveitis seems to belong to this group, whereas
patients with chronic uveitis do not carry this
antigen. Division of juvenile chronic polyarthritis
into subgroups may have prognostic value.
Sum m ar y :
Tissue typing was performed in 53 patients
with juvenile chronic polyarthritis, fulfilling the
criteria proposed by Ansell and Bywaters inl959.
14 were boys, 39 were girls. HLA-B27 was
found in 23% compared to 8% in 562 healthy con-
trols. Sacroiliitis was found in 3 boys and 3
girls, 2 in each group were B27 negative. 4
patients with B27 had acute recurrent uveitis.
2 B27 negatives had chronic uveitis. 4 patients
had a positive sheep cell test, all B27 negative
girls with polyarticular symptoms. 2 og 3 boys
with pauciarticular disease were B27 positive.
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