Clinical expression of rheumatoid arthritis in Chilean patients
| Autor: | Alfonso González, Sergio Jacobelli, Santiago J. Rivero, Vinicio Cervilla, Loreto Massardo, Verónica Aguirre, Sandra Nicovani, M. Eugenia García |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male musculoskeletal diseases Work medicine.medical_specialty Time Factors Population Rheumatoid nodule Arthritis Gastroenterology Arthritis Rheumatoid Sex Factors Rheumatology Immunopathology Internal medicine HLA-DR4 Antigen Prevalence medicine Humans Age of Onset Chile education Aged Aged 80 and over HLA-D Antigens education.field_of_study business.industry Histocompatibility Testing Homozygote Age Factors Odds ratio Middle Aged Prognosis medicine.disease Anesthesiology and Pain Medicine Rheumatoid arthritis Immunology Educational Status Female medicine.symptom Age of onset business Vasculitis |
| Zdroj: | Seminars in Arthritis and Rheumatism. 25:203-213 |
| ISSN: | 0049-0172 |
| DOI: | 10.1016/s0049-0172(95)80032-8 |
| Popis: | In populations such as Northern Europeans in which the HLA-DR4 subtypes DW14 and Dw4 show strong association with rheumatoid arthritis (RA), these alleles and the double allelic dose of the shared epitope are considered severity markers. The clinical expression of RA varies in different populations, which may be determined by variation in the prevalence of these markers. In the present study we analyzed the expression of RA in 112 consecutive Chilean patients and its relation to the prevalence of genetic factors, prompted by our previous observation that DR4 is weakly associated to RA in this population. Mean age was 50 +/- 14 years; 90% were seropositive and 87% were female, with a disease duration of 10 +/- 8 years. Extra-articular manifestations were found in 38% of patients, rheumatoid nodules in 27%, vasculitis in 8%, and Sjogren's syndrome in 29%. Functional capacity (ACR, 1991) I or II: 82%.15% of patients stopped working. Hand radiographs scored according to Steinbrocker in 89 patients: I, 21%; II, 15%; III, 43%; IV, 21%. In this series, patients with less formal education seemed to have more benign arthritis. In 97 controls and in 65 (56%) RA patients the presence of DRB1 alleles corresponding to DR1 and DR4 serotypes, to DR4-Dw subtypes, and homozygocity, were determined by polymerase chain reaction followed by specific oligonucleotide hybridization. The shared epitope was present in 53% of RA patients and in 30% of controls (P = .0048, odds ratio [OR] = 2.64). A double allelic dose of the epitope was present in 15% of RA patients compared with 4% of controls (P = .026, OR = 4.23). In a subgroup of 31 erosive RA patients we did not find a significant association of disease severity with the shared epitope in a single or double allelic dose. None of the DR4 subtypes that associate with RA in other populations was found significantly more prevalent in our patients. The severity of RA in our study compared with published series was intermediate between British patients with severe RA and Greek patients with milder disease. This may be due to the high prevalence of Dwl3*0403 in our population. |
| Databáze: | OpenAIRE |
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