HLA-B27 typing in the categorisation of uveitis in a HLA-B27 rich population.
OBJECTIVE
To determine whether HLA-B27 typing helps the clinician in the diagnostic examination of uveitis in a HLA-B27 rich population and also whether the clinical picture of HLA-B27 positive unilateral acute or recurrent anterior uveitis (AAU) is distinguishable from the idiopathic negative form.


METHODS
During a 3 year period 220 consecutive patients with undetermined uveitis at onset were examined in the Helsinki University Eye Clinic. HLA-B27 antigen was tested for 85% of the patients. Other laboratory or x ray examinations were performed on the basis of the anatomical classification of uveitis and the biomicroscopic features characteristic of uveitis associated systemic diseases.


RESULTS
HLA-B27 antigen was found significantly more often in patients with anterior (71%) and acute/recurrent unilateral (79%) uveitis than in patients with intermediate, posterior panuveitis (7%), and chronic (7%) or bilateral (12%) forms. Of the 16 cases of HLA-B27 negative unilateral AAU, five showed biomicroscopic features representing uveitis entities. The remaining 11 cases did not differ in any respect from the cases of HLA-B27 positive unilateral AAU.


CONCLUSIONS
HLA-B27 antigen helps the clinician in the diagnostic examination of unilateral AAU. Positive test results serve as a clue to search for spondyloarthropathies, and negative results indicate the need to look for specific uveitis entities and other systemic diseases. The occurrence of HLA-B27 positivity in conjunction with uveitis entities other than unilateral AAU is of the same level or less than in the population of Finland in general.
Huhtinen
M
M
Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.
Karma
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002648:Child; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015864:Panuveitis / Q000175:diagnosis / Q000276:immunology; D011446:Prospective Studies; D012008:Recurrence; D014605:Uveitis / Q000175:diagnosis* / Q000276:immunology; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000276:immunology
D015415:Biomarkers; D015796:HLA-B27 Antigen