title: Compound heterozygosity of HLA-DR4 and DR1 antigens in Asian Indians increases the risk of extra-articular features in rheumatoid arthritis.
abstract: The relationship of HLA-DR antigens in rheumatoid arthritis (RA) patients with the presence of rheumatoid factor (RF), extra-articular features, joint erosions, functional status and response to disease modifying anti-rheumatic drugs (DMARDs) was studied. Seventy-four patients with RA were serologically typed for class II antigens. Clinical features were recorded before starting DMARDs and during follow-up to assess response and side-effects. HLA-DR1 and DR4 antigens were present more frequently in patients with RA than in the general population. The presence of DR4 correlated with RF seropositivity (P < 0.001) while DR1 was associated with seronegativity (P < 0.02). Ten of the 11 patients with extra-articular features had DR1 and/or DR4. Patients with both DR4 and DR1 had a significantly higher frequency of extra-articular features compared with those with only one of these (P < 0.01). HLA-DR4 and DR1 had no relation with the presence of subcutaneous nodules, erosive changes, deformities, response to drugs and side-effects of DMARDs.
authors.affiliation: Department of Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: S
authors.initials: S
authors.lastname: Agrawal
authors.forename: A
authors.initials: A
authors.lastname: Aggarwal
authors.forename: S
authors.initials: S
authors.lastname: Dabadghao
authors.forename: S
authors.initials: S
authors.lastname: Naik
authors.forename: R
authors.initials: R
authors.lastname: Misra
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D015798:HLA-DR1 Antigen / Q000097:blood* / Q000235:genetics; D015804:HLA-DR4 Antigen / Q000097:blood* / Q000235:genetics; D006579:Heterozygote; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012307:Risk Factors
chemical_list: D018501:Antirheumatic Agents; D015798:HLA-DR1 Antigen; D015804:HLA-DR4 Antigen