Increased risk for spondylitis stigmata in apparently healthy HL-AW27 men.

Evidence for ankylosing spondylitis was sought by clinical, radiologic, and ophthalmologic examination in HL-A W27-positive men, aged 18 or older, selected from a tissue-donor population. Back pain of 3 months' duration or longer (P less than 0.05), back stiffness, restricted lumbar flexion and chest expansion, sacroiliac erosions (P less than 0.05) and sclerosis, and ophthalmologic sequels of anterior uveitis were found more often in the 24 men of the W27 group than in a control group of 31 men lacking this antigen. Based upon accepted criteria, 3 W27 persons had definite spondylitis and an additional 3 W27 persons and one control subject had findings strongly suggestive of spondylitis (P less than 0.05). This striking frequency, if extrapolated to the general population, would place approximately 1 of 4 W27-positive men at risk for this disease.