Association of intermediate uveitis with HLA-A28: definition of a new systemic syndrome?
BACKGROUND
Endogenous posterior uveitis (PU) can be associated with systemic diseases, and certain forms have strong association with HLA antigens. Much less is known regarding intermediate uveitis (IU). The purpose of this study was to determine whether IU is associated with the HLA system and whether it can be associated with systemic symptoms.


METHODS
In 179 consecutive patients consulting for uveitis, a detailed history was obtained and a physical examination performed. HLA typing for 71 HLA-A, B, DR and DQ antigens, laboratory tests, and radiography of the chest, sinuses, and sacroiliac joints were systematically performed.


RESULTS
Thirty-two patients (18%) had IU; 51 (28.5%) had PU and constituted our internal control group. Nine of the patients with IU (28%) had the HLA-A28 antigen, compared with 8.1% of a healthy control population and 8.6% of the patients with PU (P < 0.001). An associated disease was found in four patients with IU (12.5%) (none was HLA-A28) and in 45% of the patients with PU (P < 0.01). Some 67% of HLA-A28 patients with IU had arthralgias affecting the knee(s), compared with 17% of non-HLA-A28 patients and 18% of patients with PU (P < 0.05 and P < 0.01 respectively); 55% had gonalgias and hypocomplementemia compared with 9% and 2% respectively (P < 0.01 and P < 0.001).


CONCLUSIONS
IU is significantly associated with HLA-A28; patients having this antigen may represent a subset of the disease characterized by an increased prevalence of arthralgias and hypocomplementemia.
Martin
T
T
Unité d'Immunologie Clinique, Hôpital Civil Hôpitaux, Universitaries, Strasbourg, France.
Weber
M
M
Schmitt
C
C
Weber
J C
JC
Tongio
M M
MM
Flament
J
J
Sahel
J
J
Pasquali
J L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D000595:Amino Acid Sequence; D018771:Arthralgia / Q000209:etiology; D002648:Child; D003165:Complement System Proteins / Q000172:deficiency; D005260:Female; D015234:HLA-A Antigens / Q000737:chemistry / Q000235:genetics / Q000502:physiology*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D011446:Prospective Studies; D017433:Protein Structure, Secondary; D013577:Syndrome; D015867:Uveitis, Intermediate / Q000209:etiology*; D015866:Uveitis, Posterior / Q000209:etiology
D015234:HLA-A Antigens; C037164:HLA-A28 antigen; D003165:Complement System Proteins