HLA class I typing in Egyptian childhood minimal change nephrotic syndrome

Reports on the association between human leukocyte antigens (HLAs) and childhood minimal change nephrotic syndrome (MCNS) are variable. The association between HLA class I and MCNS has not been tested among Egyptian children.

We studied such associations in a group of steroid-responsive MCNS Egyptian children (n=37) in comparison to a group of healthy Egyptians (n=100). Typing was performed using standard lymphocytotoxicity assay.

The frequency of HLA-B27 was remarkably higher among MCNS children (18.9%) compared with the control group (1%) (p<0.001, risk ratio [RR] = 3.76, 95% confidence interval [95% CI], 2.5-5.66). Additionally, MCNS children had a significantly higher frequency of HLA-A11 (16.2% vs. 3%) and HLA-B13 (13.5% vs. 2%) (p=0.012 and p=0.016; RR=2.75 and RR=2.9; 95% CI, 1.58-4.79 and 1.66-5.06; respectively). With multivariate analysis, the previous 3 loci were still significant in addition to HLA-B12 (p=0.001, p=0.005, p=0.013 and p=0.033, for HLA-B27, HLA-B13, HLA-A11 and HLA-B12, respectively). The frequency of HLA haplotypes was comparable in both groups.

We concluded that associations of HLA class I with childhood MCNS in Egypt have both similarities and dissimilarities to those in other populations. HLA-B27, which has not been reported before, has the strongest association. However, similar to studies from other populations, HLA-A11, HLA-B13 and HLA-B12 loci were also associated with MCNS.