Paternal histocompatibility (HLA) antigens and maternal anti-HLA antibodies in herpes gestationis

It has been suggested that anti-HLA antibodies might be involved in the pathogenesis of herpes gestationis (HG). Accordingly, we have studied the frequency and specificity of such antibodies in 26 female patients with immunologically proven HG. In addition, to further investigate the potential association of the husband's antigens in the development of this disorder, we have performed HLA typing in 20 of the husbands of these women. HLA-DR2 was found in 50% of the husbands (controls 25%, p = 0.04). The increase was more pronounced in the husbands of patients with the HLA-DR3, DR4 combination (64%, p less than .01) than in the husbands of those with other antigen combinations. Anti-HLA antibodies were found in 85% of women with a history of HG. Approximately 25% of normal, multiparous women have such antibodies in their sera. In normal women, their presence has not been associated with increased fetal or maternal risk. These data suggest that the husband's HLA type may be associated with the development of HG in the wife. Anti-HLA antibodies are present in most patients, but their significance remains uncertain.