HLA-DRw4 in pemphigus vulgaris patients in Israel

Pemphigus vulgaris (PV) is relatively common in Jews. Three HLA antigens were significantly more frequent in 39 Israeli Jewish PV patients than in controls A26 - 59% vs 20%; Bw38 - 61% vs 20%; and DRw4 - 90% vs 38%. The joint occurrence of A26-Bw38-DRw4 was observed in 46% of PV patients and in 10% of controls. Similar results were recently reported for Jews in the Los Angeles area. Yet, when our patient sample was grouped into Ashkenazi and non-Ashkenazi Jews, it was evident that each of the three antigens had a higher frequency both in Ashkenazi patients and controls as compared to non-Ashkenzai. The relative risk for DRw-4 in Ashkenzim was 33.8 as compared to 14.4 in the total sample of Israeli PV patients. The phenotype A26-Bw38-DRw4 was present in 57% of Ashkenazi patients and in 13% of controls. Ashkenazi Jews have the highest prevalence of PV, and HLA associations were strongest with Ashkenazi PV patients. These associations were with three antigens, all of high frequency in that group.