[Clinical characteristic of optic neuritis and its relevancy with human leukocyte antigen].
OBJECTIVE
To investigate clinical characteristics of optic neuritis and its association with HLA (human leukocyte antigen).


METHODS
The clinical data of 42 patients with optic neuritis were collected and flow polymerase chain reaction-reverse sequence specific oligonucleotide probe (PCR-rSSOP) was used to determine the genotype of HLA-DRB1.


RESULTS
Two patients confirmed as Leber hereditary optic neuropathy by gene sequencing were excluded from the study. The complaint of pain was found in the patients (31/40) of optic neuritis. The visual field defect varied with patients and central and pericentral scotoma were demonstrated in 7 patients of 17. Of 40 patients with optic neuritis, 20 (50.0%) showed multifocal brain lesions in white matter by MR scanning. 26 of 38 patients had increased STIR signals. Inflammatory demyelinating changes were found in cerebral spinal fluid in 21 patients (80.8%). Out of demonstrated brain abnormal was revealed in 29 (72.5%) patients using MRI and/or CSF examination. The rate of HLA-DRB1(*)15 in the patients (35.0%) was much higher than control (19.4%), (chi(2) = 4.2328, P = 0.0397). Frequencies of HLA-DRB1(*)15 increased significantly in 26 female patients. The increased frequencies of HLA-DRB1(*)15 were associated with CSF abnormality and no relevancy was found with onset times, brain MR changes and increase of optic nerve signals. Acute optic neuritis responded well to intravenous megadose of methylprednisolone or immunoglobulin.


CONCLUSIONS
Most of optic neuritis was characterized as clinical inflammatory demyelinating disease. HLA-DRB1(*)15 might correlated with genetic susceptibility of female patients with optic neuritis.
Lai
Chun-tao
CT
Department of Neurology, Tongren Hospital, Capital University of Medical Science, Beijing 100730, China. laichunt@163.com
Li
Wei
W
Sun
Yan-bin
YB
Meng
Chao
C
Chi
Ke-mei
KM
Lu
Chang-feng
CF
Yu
Hua-feng
HF
Zhang
Zhi-xin
ZX
D000293:Adolescent; D000328:Adult; D000483:Alleles; D002648:Child; D003711:Demyelinating Diseases / Q000175:diagnosis; D005260:Female; D020022:Genetic Predisposition to Disease; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006801:Humans; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D012737:Sex Factors
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains