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HLA-B27 predicts a ...
HLA-B27 predicts a more extended disease with increasing age at onset in boys with juvenile idiopathic arthritis
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- Berntson, Lillemor, 1957- (author)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa,Pediatrisk inflammationsforskning/Nevéus
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- Damgård, M. (author)
- Department of Pediatrics, Falun Hospital
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- Andersson-Gäre, Boel (author)
- Jönköping University,HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete,Department of Pediatrics, Ryhov County Hospital
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- Herlin, T. (author)
- Århus University Hospital
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- Nielsen, S. (author)
- University Clinic of Pediatrics II, Rigshospitalet
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- Nordal, E. (author)
- Institute of Clinical Medicine/Institute of Community Medicine, University of Tromsø
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- Rygg, M. (author)
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Norwegian University of Science and Technology
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- Zak, M. (author)
- University Clinic of Pediatrics II, Rigshospitalet
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- Fasth, Anders, 1945 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Department of Pediatrics, Göteborg University
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(creator_code:org_t)
- 2008
- 2008
- English.
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In: British Journal of Rheumatology. - 0263-7103 .- 1460-2172 .- 0315-162X .- 1499-2752. ; 35:10, s. 2055-2061
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Abstract
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- OBJECTIVE: Juvenile idiopathic arthritis (JIA) is a heterogeneous condition with very few clinical and laboratory signs that can help predict the course and severity of the disease in the individual patient. The cell-surface antigen HLA-B27 is well known to be associated with spondyloarthropathies, reactive arthritis, and enthesitis. HLA-B27 plays an important role in the classification of JIA, since evidence of sacroiliitis most often evolves after years of arthritis in other joints. We investigated the associations of HLA-B27 and the clinical manifestations of JIA using a method as close to a population-based study as possible.METHODS: We studied an incidence-based cohort of 305 patients collected prospectively in 3 Nordic countries (Sweden, Norway, Denmark). Clinical and serological data of the first 3 years of the disease were collected.RESULTS: HLA-B27 was found to be positive in 25.5% of the patients, and we found a higher proportion of HLA-B27-positive boys with older age at disease onset (p=0.034). Regression analysis showed a correlation of 0.7 in the HLA-B27-positive boys, pointing to a higher risk of more joint involvement with older age at disease onset. By Fisher's exact test, involvement of small joints in the lower extremities was associated with HLA-B27 in boys (p=0.011), but not in girls (p=0.687). HLA-B27 was associated with inflammatory back pain in both sexes (p=0.041 in boys, p=0.042 in girls), but with enthesitis only in boys (p<0.001 in boys, p=0.708 in girls).CONCLUSION: HLA-B27 is of increasing importance with older age at disease onset in boys with JIA, predicting more active joints within the first 3 years of disease, and also involving small joints in the lower extremity to a greater degree than in HLA-B27-negative boys. During the first 3 years of disease the occurrence of HLA-B27 is associated with inflammatory back pain in both sexes, but with enthesitis only in boys. Our data present new challenges for the ILAR classification of JIA.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- Adolescent
- Age of Onset
- Arthritis
- Juvenile Rheumatoid/genetics
- Child
- Child
- Preschool
- Denmark
- Disease Progression
- Female
- Genetic Predisposition to Disease/genetics
- HLA-B27 Antigen/genetics
- Humans
- Longitudinal Studies
- Male
- Norway
- Sex Factors
- Sweden
- MEDICINE
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Berntson, Lillem ...
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Damgård, M.
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Andersson-Gäre, ...
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Herlin, T.
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Nielsen, S.
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Nordal, E.
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Rygg, M.
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Zak, M.
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Fasth, Anders, 1 ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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British Journal ...
- By the university
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Jönköping University
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University of Gothenburg
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Uppsala University