HLA-DR4 associated response to corticosteroids in Graves' ophthalmopathy patients.
Fifty-seven patients with severe Graves' ophthalmopathy were treated with corticosteroids. Therapeutic outcome was assessed according to predetermined criteria as response (n = 37) or non-response (n = 20) to therapy. Patients were typed for HLA-A, -B, -C, -DR and -DQ. HLA-DR4 was completely absent in the 20 non-responder patients (corrected p value = 0.042). In the responder group 14 of the 37 patients were HLA-DR4 positive. This study shows that in Graves' ophthalmopathy patients the presence of HLA-DR4 is associated with a good response to corticosteroid therapy. The frequency of HLA-DR4 in the Graves' ophthalmopathy population as a whole, however, was not different from normal (25% versus 26%). But as reported previously, the frequency of HLA-DR3 was significantly increased in the Graves' ophthalmopathy patients when compared to healthy blood donors (47% versus 24%, corrected p value = 0.02). No significant deviations were found in the HLA-A, -B, or -C loci.
van der Gaag
R
R
Department of Ophthalmo-Immunology, The Netherlands Ophthalmic Research Institute, Amsterdam.
Wiersinga
W M
WM
Koornneef
L
L
Mourits
M P
MP
Prummel
M F
MF
Berghout
A
A
de Vries
R R
RR
Schreuder
G M
GM
D'Amaro
J
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D005128:Eye Diseases / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000276:immunology*; D015804:HLA-DR4 Antigen / Q000502:physiology*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D000305:Adrenal Cortex Hormones; D015804:HLA-DR4 Antigen