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HLA ‐ DR typing in polyarticular juvenile idiopathic arthritis: a study from a tertiary care hospital in northern I ndia
Author(s) -
Dibya Ranjan Behera,
Nand Kumar Singh,
Usha Singh,
Pramod Kumar Verma
Publication year - 2014
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12198
Subject(s) - medicine , tertiary care , typing , arthritis , human leukocyte antigen , immunology , microbiology and biotechnology , antigen , family medicine , biology
Many studies of human leukocyte antigen ( HLA ) association with juvenile idiopathic arthritis ( JIA ) have reported conflicting results, which were probably related to ethnic differences. Moreover, in India, studies on HLA ‐ DR typing on JIA , particularly polyarticular JIA , is lacking. Objective The aim of our study was to reveal the frequency of HLA DR types in a cohort of polyarticular JIA in northern India. Methods Fifty‐two polyarticular JIA patients were included as per the recent International League of Associations for Rheumatology classification, 2001. HLA ‐ DR typing was performed in 21 patients (18 rheumatoid factor [ RF ]+ and three RF −) by a DNA ‐based polymerase chain reaction method for the determination of HLA alleles using sequence specific primers ( SSP ). The results were compared with that of 23 healthy controls of the same age and sex. Results HLA ‐ DR 4 was present in five cases (23%) in the diseased group while only in one case (4.3%) in the control group with a relative risk of 5.47, but when compared with only RF + polyarticular JIA , HLA ‐ DR 4 was found to be significantly high (27.7% vs . 4.43%; P < 0.05) with a relative risk of 6.3. Further, DR 4, DR 1, DR 2, DR 9, DR 10 were also non‐significantly high in these patients with relative risk of 3.2 for DR 9 and 1.8 for DR 10. In contrast, HLA ‐ DR 6 was seen only in 5.5% of polyarticular JIA cases, whereas it was present in 39% of controls ( P < 0.05), a showing negative association. Conclusion HLA ‐ DR 4 codes for susceptibility to RF + polyarticular JIA with a six‐fold risk, whereas HLA ‐ DR 6 offers protection.