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Longitudinal analysis of HLA associated risks for iridocyclitis in juvenile rheumatoid arthritis
E H Giannini1, C N Malagon, C Van Kerckhove
1Division of Rheumatology, Children's Hospital Medical Center, Cincinnati, OH 45229.
Insights
Children with early onset pauciarticular juvenile rheumatoid arthritis (EOPA-JRA) carrying the HLA-DR5 haplotype face a higher risk of developing iridocyclitis. The HLA-DR1 haplotype appears to be protective against this serious eye condition.
Area of Science:
- Rheumatology
- Ophthalmology
- Immunogenetics
Background:
- Iridocyclitis is a significant complication in children with early onset pauciarticular juvenile rheumatoid arthritis (EOPA-JRA).
- Specific Human Leukocyte Antigen (HLA) haplotypes are associated with the risk of developing iridocyclitis in EOPA-JRA patients.
Purpose of the Study:
- To perform an actuarial analysis of iridocyclitis risk in EOPA-JRA.
- To estimate haplotype-specific risks for developing iridocyclitis.
- To compare the risk associated with HLA-DR5 and HLA-DR1 haplotypes.
Main Methods:
- Actuarial analysis using one-year intervals.
- Inclusion of 161 subjects with EOPA-JRA.
- Estimation of haplotype-specific risks and comparison of life-table curves.
Main Results:
- Individuals with the HLA-DR5 haplotype showed earlier onset and higher frequency of iridocyclitis.
- Subjects with the HLA-DR1 haplotype demonstrated a protective effect against iridocyclitis.
- Statistically significant differences (p = 0.00003) were observed between HLA-DR5 and HLA-DR1 positive groups.
Conclusions:
- HLA-DR5 is a major susceptibility haplotype for iridocyclitis in EOPA-JRA.
- HLA-DR1 is a protective haplotype against iridocyclitis in this patient group.
- Time-oriented risk estimates can assist clinicians in predicting iridocyclitis probability.
Abstract:
The risk of iridocyclitis in children with early onset pauciarticular juvenile rheumatoid arthritis (EOPA-JRA) has been shown to be associated with certain HLA haplotypes. Our report contains an actuarial analysis, using one-year intervals, of 161 subjects and estimates haplotype specific risks. Individuals who possess the major susceptibility haplotype HLA-DR5 (11) developed eye disease earlier and with a greater frequency than did those with the protective HLA-DR1 haplotype. Highly significant differences were found between the resulting life-table curves for HLA-DR5 and HLA-DR1 positive subjects (p = 0.00003). These time oriented risk estimates may aid clinicians in determining more precisely the probability of iridocyclitis throughout the course of the disease in children with EOPA-JRA.