[Uveitis in spondyloarthritis patients and its association with HLA-B27 histocompatibility antigen: prospective study].
OBJECTIVE
to perform a prospective study of clinical presentation and course of uveitis in spondyloarthritis (SpA) patients as well as its association with the HLA-B27 histocompatibility antigen.


METHODS
The study included 219 patients with uveitis, all tested for HLA-B27 antigen and various infections (viral, bacterial, and parasitic) as well as examined for locomotive system involvement.


RESULTS
The presence of the HLA-B27 antigen was determined in 142 (64.8%) out of 219 patients, of them 87 were diagnosed with an entity of the SpA group. The remaining 77 (35.2%) patients appeared to be HLA-B27-negative, but 13 were still diagnosed with an entity of the SpA group. There were 10 (4.6%) patients with 2 or more diseases from the SpA group («clinical decussation»). When comparing the two groups of HLA-B27-positive and negative patients having both SpA and uveitis, no statistically significant difference was found as to the age of onset, site, frequency of attacks, and uni- or bilateral involvement (p>0.05). We also performed a comparison of HLA-B27-positive and negative patients with no account to their SpA status and revealed a higher complication rate in those that were «negative» (p<0.0001), which can be explained by the fact that HLA-B27-negative patients often have autoimmune or infectious uveitis of different origin notable for long attacks and short remissions.


CONCLUSIONS
Assessing the site and course of uveitis as well as HLA-B27 testing of uveitis patients has proved important for etiological diagnosis. Diseases of the SpA group have been shown to be 6.7 times more common in HLA-B27-positive patients as compared to HLA-B27-negative ones. Clinical presentation of uveitis in the presence of SpA in both HLA-B27-positive and negative patients resembles that of idiopathic uveitis - an independent HLA-B27-associated syndrome (р>0.05). Cases of «decussation» between entities of the SpA group are usually more severe in terms of clinical presentation and course of uveitis and are associated with a worse prognosis. Complications of uveitis are more likely to be found in non-SpA HLA-B27-negative patients (р<0.0001).
Research Institute of Eye Disease, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021.
I Yu
IY
Razumova
Russian Medical Academy of Postgraduate Education, Ministry of Health of the Russian Federation, 2/1 Barrikadnaya St., Moscow, Russian Federation, 123995.
A A
AA
Godzenko
Research Institute of Eye Disease, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021.
O K
OK
Vorob'eva
Research Institute of Rheumatology named after V.N. Nasonova, 34a Kashirskoe Shosse, Moscow, Russian Federation, 115522.
I A
IA
Guseva
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis / Q000097:blood; D006801:Humans; D008297:Male; D062072:Patient Acuity; D011446:Prospective Studies; D012426:Russia / Q000453:epidemiology; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D013223:Statistics as Topic; D014605:Uveitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000503:physiopathology
D015796:HLA-B27 Antigen