title: A systematic survey of HLA-A,B,C and D antigens and drug toxicity in rheumatoid arthritis.
abstract: One hundred sixty-two consecutive patients with rheumatoid arthritis (RA) were studied for possible association between HLA antigens, particularly DR antigens, and disease characteristics and adverse reactions to gold or D-penicillamine treatment. The frequency of HLA-DR4 was significantly increased: 62% in RA compared to 23% in controls. An association of HLA-DR4 with a positive family history for RA was also found. HLA-DR4 was not associated with subcutaneous nodules or keratoconjunctivitis, presence of rheumatoid factor, or ANA positivity. No increased prevalence of HLA-DR3 was found in patients who developed drug related toxicity (e.g., proteinuria for gold or D-penicillamine). Of the 27 patients in whom proteinuria developed, only 5 were DR3 positive. A significant association with D-penicillamine induced proteinuria and HLA-B8 gene was found. Our results obtained in a systematic survey do not confirm previous reports of a significant association between HLA-DR3 and drug toxicity, but confirm the association between HLA-DR4 and the development of RA and HLA-B8 and D-penicillamine induced proteinuria.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000276:immunology*; D003601:Cytotoxicity Tests, Immunologic; D003872:Dermatitis / Q000139:chemically induced; D004112:Dimercaprol / Q000009:adverse effects / Q000031:analogs & derivatives; D004361:Drug Tolerance; D005260:Female; D005455:Fluorescent Antibody Technique; D006046:Gold / Q000009:adverse effects; D006680:HLA Antigens / Q000276:immunology*; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006684:HLA-DR Antigens; D006417:Hematuria / Q000139:chemically induced; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D050607:Organogold Compounds; D009942:Organometallic Compounds; D010396:Penicillamine / Q000009:adverse effects; D020005:Propanols; D011507:Proteinuria / Q000139:chemically induced; D013280:Stomatitis / Q000139:chemically induced; D013438:Sulfhydryl Compounds
chemical_list: D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D006684:HLA-DR Antigens; D000949:Histocompatibility Antigens Class II; D050607:Organogold Compounds; D009942:Organometallic Compounds; D020005:Propanols; D013438:Sulfhydryl Compounds; D004112:Dimercaprol; D006046:Gold; C013394:aurotioprol; D010396:Penicillamine