General paralysis of the insane associated with HLA-Aw32

HLA-A, -B, and -C locus antigens were determined in 35 unrelated patients with general paralysis of the insane (GPI), and in 13 neurosyphilis patients without dementia. HLA-Aw32 was found more frequently (corrected p = 4.9 x 10(-2) in the GPI patients than in 1009 controls. None of the patients having neurosyphilis without dementia had HLA-Aw32. These findings indicate that genetically determined mechanisms may play a role in development of GPI. Further studies of such rare patients should be initiated to investigate whether these observations reflects a true association or whether they are due to chance. If possible other well defined groups of tertiary syphilis should also be studied.