HLA-B27 expression and reactive arthritis susceptibility in two patient cohorts infected with Salmonella Typhimurium.
BACKGROUND
Reactive arthritis (ReA) is an inflammatory arthritis triggered by certain gastrointestinal and genitourinary infections. Single source outbreaks of triggering infections provide an opportunity to elucidate host susceptibility factors in this disease.


OBJECTIVE
To determine the role of Major Histocompatibility Complex (MHC) Class I alleles in ReA susceptibility after two large single source outbreaks of Salmonella Typhimurium gastroenteritis.


METHODS
A questionnaire screening for features of ReA and a request for HLA class I typing were sent to all patients affected by two single source outbreaks of S. Typhimurium gastroenteritis. Individuals with arthritis of recent onset were interviewed, examined and diagnostic criteria for ReA applied.


RESULTS
Nineteen cases of reactive arthritis, 11 female, were diagnosed in the 424 respondents with S. Typhimurium gastroenteritis from both outbreaks. Clinical features of the arthritis were similar to those described after other large single source outbreaks of Salmonella infection. HLA-B27 was expressed by only two of the 19 ReA patients and therefore did not predict susceptibility to this form of arthritis. Caucasians were, however, more likely to develop reactive arthritis than Asians.


CONCLUSIONS
In this study, susceptibility to ReA was not increased in HLA-B27 positive individuals or males but was greater in those of Caucasian descent.
McColl
G J
GJ
Centre for Rheumatic Diseases, Royal Melbourne Hospital, Parkville, Vic. g.mccoll@medicine.unimelb.edu.au
Diviney
M B
MB
Holdsworth
R F
RF
McNair
P D
PD
Carnie
J
J
Hart
W
W
McCluskey
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016918:Arthritis, Reactive / Q000209:etiology / Q000235:genetics*; D044466:Asian People / Q000235:genetics; D001315:Australia / Q000453:epidemiology; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D020022:Genetic Predisposition to Disease; D015796:HLA-B27 Antigen; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D000091402:Prohibitins; D012478:Salmonella Food Poisoning / Q000150:complications* / Q000453:epidemiology; D044465:White People / Q000235:genetics
D015796:HLA-B27 Antigen; C000717331:PHB2 protein, human; D000091402:Prohibitins