rss
Ann Rheum Dis 1999;58:303-308 doi:10.1136/ard.58.5.303
  • Extended reports

HLA-DRB1 alleles associated with polymyalgia rheumatica in northern Italy: correlation with disease severity

  1. Carlo Salvarania,
  2. Luigi Boiardia,
  3. Vilma Mantovanib,
  4. Andrea Ranzic,
  5. Fabrizio Cantinid,
  6. Ignazio Olivierie,
  7. Michela Braglianib,
  8. Elisa Collinab,
  9. PierLuigi Macchionia
  1. aServizio di Reumatologia, Arcispedale S Maria Nuova, Reggio Emilia, Italy, bLaboratorio Centralizzato, Settore Tipizzazione Tissutale, Ospedale S Orsola-Malpighi, Bologna, Italy, cCattedra di Biometria e Statistica Medica, Istituto di Igiene, Università di Modena, Italy, dUnità Reumatologica, Ospedale di Prato, Prato, Italy, eUnità di Reumatologia, Ospedale S Carlo, Potenza, Italy
  1. Dr C Salvarani, Servizio di Reumatologia, Azienda Ospedaliera Arcispedale S Maria Nuova, V le Umberto 1 N50, 42100 Reggio Emilia, Italy.
  • Accepted 15 February 1999

Abstract

OBJECTIVE To examine the association of HLA-DRB1 alleles with polymyalgia rheumatica (PMR) in a Mediterranean country and to explore the role of HLA-DRB1 genes in determining disease severity.

METHODS A five year prospective follow up study of 92 consecutive PMR patients diagnosed by the secondary referral centre of rheumatology of Reggio Emilia, Italy was conducted. HLA-DRB1 alleles were determined in the 92 patients, in 29 DR4 positive rheumatoid arthritis (RA) patients, and in 148 controls from the same geographical area by polymerase chain reaction amplification and oligonucleotide hybridisation.

RESULTS No significant differences were observed in the frequencies of HLA-DRB1 types and in the expression of HLA-DRB 70–74 shared motif between PMR and controls. The frequency of the patients with double dose of epitope was low and not significantly different in PMR and in controls. No significant differences in the distribution of HLA-DR4 subtypes were observed between DR4+ PMR, DR+ RA, and DR4+ controls. Results of the univariate analysis indicated that an erythrocyte sedimentation rate (ESR) at diagnosis > 72 mm 1st h, the presence of HLA-DR1, DR10, rheumatoid epitope, and the type of rheumatoid epitope were significant risk factors associated with relapse/recurrence. Cox proportional hazards modelling identified two variables that independently increased the risk of relapse/recurrence: ESR at diagnosis > 72 mm 1st h (RR=1.5) and type 2 (encoded by a non-DR4 allele) rheumatoid epitope (RR=2.7).

CONCLUSION These data from a Mediterranean country showed no association of rheumatoid epitope with PMR in northern Italian patients. A high ESR at diagnosis and the presence of rheumatoid epitope encoded by a non-DR4 allele are independent valuable markers of disease severity.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.