2018 / 4 January

HLA-B27-Associated Diseases


The HLA-B27 allele is associated with seronegative spondyloarthropathies (SpA). The first HLA haplotype association with inflammatory disease was discovered in 1972, correlating HLA-B27 with ankylosing spondylitis. SpA includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis, and IBD-related arthritis.

SpA typically manifest with inflammatory axial or peripheral joint pain. This pain is associated with morning stiffness, is reduced with activity, and worsens with rest.

The HLA-B27-associated diseases are:

  • Acute Anterior Uveitis and  Anterior scleritis
  • Ankylosing Spondylitis
    HLA-B27 appears in 80-90% of patients with ankylosing spondylitis
  • Reactive Arthritis or Reiter syndrome
    It was originally described as a triad of arthritis, nonspecific urethritis, and conjunctivitis.
  • Inflammatory Bowel Disease
  • IgA nephropathy
  • Psoriatic Arthritis
    HLA-B27 is associated with the pustular form of psoriasis

Curiously, HLA-27 has been associated with protective action in viral infections, including HIV, HCV, influenza, EBV, HSV-2.

References

  • Zochling J, Smith EU. Seronegative spondyloarthritis. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):747-56. doi: 10.1016/j.berh.2011.02.002. (link)
  • Nicholas J. Sheehan; HLA-B27: what’s new?, Rheumatology, Volume 49, Issue 4, 1 April 2010, Pages 621–631, https://doi.org/10.1093/rheumatology/kep450 (link)

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