Unsal E, Gülay Z, Günal I
Department of Pediatrics, Dokuz Eylül University, School of Medicine, Izmir, Turkey.
Arch Orthop Trauma Surg. 2001 Nov;121(10):571-3. doi: 10.1007/s004020100300.
Seventeen children who met the criteria for juvenile chronic arthritis (JCA) were reviewed. Throughout the study, the clinical examination, HLA phenotyping, and radiological assessment of the hips were performed by separate authors who were blinded to other data. At the end of the study, the results were also compared with 25 healthy, age- and sex-matched children. Six of the children with JCA also had radiological signs of slipped capital femoral epiphysis (SCFE; five with minimal slip pattern, one with moderate slip), and five of them had DR4 in their genotypes, in contrast to the remaining 11 patients who did not (p < 0.001). On the other hand, only 2 of 25 children in the control group had DR4 (p < 0.01). The difference was not significant when the patients without SCFE were compared with the control group (p = 1.0). The relative risk of cases with DR4 antigen for SCFE was 57.5, while it was below I for the other antigens. These results suggest that although DR4 is not specific for JCA, it is the common HLA antigen for those who have SCFE, and patients with JCA and HLA-DR4 antigen should be examined for evidence of SCFE, which was not reported before to exist with JCA.
对17名符合青少年慢性关节炎（JCA）标准的儿童进行了回顾性研究。在整个研究过程中，对髋关节的临床检查、HLA分型和放射学评估由不同的作者进行，他们对其他数据不知情。在研究结束时，还将结果与25名年龄和性别匹配的健康儿童进行了比较。6名JCA患儿同时有股骨头骨骺滑脱（SCFE）的放射学表现（5例为轻度滑脱型，1例为中度滑脱），其中5例基因型为DR4，其余11例则没有（p<0.001）。另一方面，对照组25名儿童中只有2例有DR4（p<0.01）。将无SCFE的患者与对照组进行比较时，差异无统计学意义（p = 1.0）。携带DR4抗原的病例发生SCFE的相对风险为57.5，而其他抗原的相对风险低于1。这些结果表明，虽然DR4并非JCA所特有，但它是发生SCFE患儿中常见的HLA抗原，JCA且携带HLA-DR4抗原的患者应检查是否有SCFE迹象，此前未见JCA合并SCFE的报道。
