Poststreptococcal reactive arthritis: clinical characteristics and association with HLA-DR alleles.
OBJECTIVE
To assess the relationship of poststreptococcal reactive arthritis (ReA) to other forms of ReA and rheumatic fever by comparing the frequency of HLA-B27 and DRB1 alleles in these diseases.


METHODS
The diagnosis of poststreptococcal ReA was established in 25 children seen in a pediatric rheumatology clinic. HLA-B27 and DRB1 genotyping was performed in 18 of the white American patients. The DRB1 genotyping results were compared with those in 33 patients with rheumatic fever and 190 normal individuals.


RESULTS
HLA-B27 was positive in 3 of the 18 poststreptococcal ReA patients, a frequency not different from that found in normal individuals. Compared with normal controls, the frequency of the DRB1*01 allele was higher in poststreptococcal ReA patients (odds ratio [OR] 2.7, P=0.044), while DRB1*16 was increased in patients with rheumatic fever (OR 4.3, P=0.028).


CONCLUSIONS
The association of poststreptococcal ReA with HLA-DRB1*01, but not with HLA-B27, suggests that its pathogenesis may be more similar to that of rheumatic fever than to that of ReA associated with enteric pathogens.
Ahmed
S
S
University of Florida, Gainesville 32610, USA.
Ayoub
E M
EM
Scornik
J C
JC
Wang
C Y
CY
She
J X
JX
D000293:Adolescent; D000483:Alleles; D016918:Arthritis, Reactive / Q000276:immunology* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005787:Gene Frequency; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006801:Humans; D008297:Male; D000091402:Prohibitins; D012016:Reference Values; D012213:Rheumatic Fever / Q000276:immunology; D013290:Streptococcal Infections / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C000717331:PHB2 protein, human; D000091402:Prohibitins