Abstract
To determine whether genetic markers for chronic iridocyclitis could be identified, we used both serologic and oligonucleotide dot blot techniques to characterize immunogenetically 164 children with early-onset pauclarticular juvenile rheumatoid arthritis. Seventy-eight children (47.6%) had chronic iridocyclitis and 86 (52.4%) had not had evidence of eye disease during a mean follow-up period after the onset of arthritis of 15.8 years (minimum of 5.5 years). Control subjects were 218 healthy, unrelated individuals. The analysis was limited to alleles known to be associated with an increased or decreased risk of early-onset pauciarticular juvenile rheumatoid arthritis or of chronic iridocyclitis in this form of juvenile rheumatoid arthritis. Only one split of human leukocyte antigen (HLA)-DR5, HLA-DRB1*1104, showed a statistically significant association with a risk of chronic iridocyclitis (chi-square value=7.52; p=0.036 adjusted; odds ratio 3.45); HLA-DQA1*0501 and HLA-DQB1*0301, both in linkage disequilibrium with HLA-DRB1*1104, also were significantly associated with eye disease. Patients with both the DRB1*1104 and DPB1*0201 genes had a 7.7-fold increased risk for chronic iridocyclitis compared with that for other patients. The presence of HLA-DRB1*1104 was about four times as specific, but only about one third as sensitive, as antinuclear antibodies in identifying patients at risk for eye disease. Although all children with early-onset pauciarticular juvenile rheumatoid arthritis should undergo periodic slit-lamp examinations, those with the HLA class II gene DRB1*1104 are at particularly high risk for eye disease, and we recommend that they be monitored carefully for its evolution.
Original language | English (US) |
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Pages (from-to) | 56-60 |
Number of pages | 5 |
Journal | The Journal of pediatrics |
Volume | 121 |
Issue number | 1 |
DOIs | |
State | Published - Jul 1992 |
Funding
Chronic nongranulomatous inflammation of the anterior uveal tract involving the iris and ciliary body (chronic iridocyclitis) is a prominent clinical complication of juvenile rheumatoid arthritis. Chronic iridocyclitis is most prevalent Supported by grants from the Arthritis Foundation, the National Institutes of Health (Nos. R01 AR39979 and AR21393), the Schmidlapp Foundation, the Children's Hospital Research Foundation, Cincinnati, Ohio, and the Lion'~ Club of Ohio. Submitted for publication Dec. 16, 1991; accepted Feb. 13, 1992. Reprint requests: Edward H. Giannini, MS, DrPH, Division of Rheumatology, PAV-1, Children's Hospital Medical Center, El-land and Bethesda Boulevard, Cincinnati, OH 45229. 9/20/37099 among children in whom arthritis develops in fewer than five joints at the time of articular disease onset; this type is referred to as pauciarticular (oligoarticular) JRA. The frequency of iridocyclitis among those with pauciarticular
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health