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Bartonella henselae associated uveitis and HLA-B27
1Department of Ophthalmology, FC Donders Institute, University Hospital, 3508 GA Utrecht, Netherlands. fkerkho@oogh.azu.nl
The British Journal of Ophthalmology
|September 27, 2000
Summary
The human leukocyte antigen B27 (HLA-B27) is more common in patients with presumed ocular bartonellosis (POB) and uveitis. HLA-B27 positive patients with POB often experience severe posterior segment inflammation and a chronic disease course.
Area of Science:
- Ophthalmology
- Immunogenetics
- Infectious Diseases
Background:
- Presumed ocular bartonellosis (POB) is a potential cause of uveitis.
- The association between HLA-B27 and POB requires further investigation.
Observation:
- This study investigated HLA-B27 frequency in 19 patients with POB and uveitis.
- A control group of 25 patients with panuveitis and negative Bartonella serology was included.
- Patients with POB underwent extensive diagnostic screening, with normal results except for Bartonella serology.
Findings:
- HLA-B27 was positive in 32% of POB patients, significantly higher than the 4% in controls (p=0.03).
- HLA-B27 positive POB patients frequently presented with severe posterior segment involvement (papillitis, macular edema, vitreitis).
- The ocular inflammation in HLA-B27 positive POB patients was often chronic (>6 months) and distinct from prior anterior uveitis episodes.
Implications:
- The higher prevalence of HLA-B27 in POB suggests a potential genetic predisposition or link.
- These findings highlight the importance of considering Bartonella infection in HLA-B27 positive uveitis patients.
- Further research is warranted to elucidate the specific mechanisms underlying the association between HLA-B27 and Bartonella-related ocular disease.