title: Effect of HLA type and hypocomplementaemia on the expression of parvovirus arthritis: one year follow up of an outbreak.
abstract: OBJECTIVE
  To determine the effect of HLA type and hypocomplementaemia on the duration and severity of joint involvement in parvovirus infection (HPV).
  
  
  METHODS
  Forty seven patients were selected on a geographical basis from 83 with proven HPV infection during an outbreak that occurred in Oxfordshire in 1993. They were contacted by questionnaire a year later. Thirty five patients were available for examination and blood sampling. Subjects were typed for HLA-DRB1 alleles and HLA-B27 status. Immunological profiles, including C3 and C4 complement components, were determined.
  
  
  RESULTS
  Joint symptoms occurred in all patients. They resolved within a week in 12 patients and persisted beyond one year in 19. On review, none had a picture of rheumatoid arthritis, but three patients had developed carpal tunnel syndrome. Decreased C4 was found in four. The HLA frequencies were similar to those in controls; however, joint symptoms persisted for more than one week in all HLA-DR4 positive patients (p = 0.009). There was no relation between the severity of joint symptoms and either HLA type, or hypocomplementaemia.
  
  
  CONCLUSIONS
  Joint symptoms are common in parvovirus infection and the presence of HLA-DR4 may be associated with persistence of joint symptoms beyond one week. This study revealed no evidence of progression to rheumatoid arthritis.
authors.affiliation: Rheumatology Department, Nuffield Orthopaedic Centre, Oxford, United Kingdom.
authors.forename: N S
authors.initials: NS
authors.lastname: Gendi
authors.forename: K
authors.initials: K
authors.lastname: Gibson
authors.forename: B P
authors.initials: BP
authors.lastname: Wordsworth
mesh_terms: D000328:Adult; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000276:immunology*; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D003165:Complement System Proteins / Q000032:analysis*; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D016731:Erythema Infectiosum / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000032:analysis*; D015796:HLA-B27 Antigen / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D003176:Complement C3; D003181:Complement C4; D006680:HLA Antigens; D015796:HLA-B27 Antigen; D006684:HLA-DR Antigens; D003165:Complement System Proteins