Ghosh Kanjaksha, Shankarkumar Umapathy, Shetty Shrimati, Mohanty Dipika
Institute of Immunohaematology, Floor 13, New Building, KEM Hospital Campus, Parel, 400 012, Mumbai, India.
Lancet. 2003 Mar 15;361(9361):933-4. doi: 10.1016/S0140-6736(03)12763-8.
Chronic synovitis affects about 10% of patients with severe haemophilia in India. This disease has some features in common with ankylosing spondylitis, which has been linked to HLA B27. We therefore aimed to test whether there is an association between HLA B27 and chronic synovitis. We studied 473 patients with severe haemophilia (33 of whom had chronic synovitis), and 1175 healthy controls using a standard serological technique and the reverse line strip assay. 64% (21 of 33) of patients with haemophilia and chronic synovitis were positive for HLA B27, compared with 5% (23 of 440) of those with severe haemophilia, but not chronic synovitis (odds ratio 31.6 [95% CI 9.28-39.38], p<0.0001), and 9% (100 of 1175) of healthy controls (18.81 [9.6-27.7], p<0.0001). We conclude that there is a strong association between HLA B27 and chronic synovitis in Indian patients with severe haemophilia and screening in this population could allow treatment and prevention of the complication.
在印度，慢性滑膜炎影响着约10%的重度血友病患者。这种疾病具有一些与强直性脊柱炎相同的特征，而强直性脊柱炎已被证明与HLA B27相关。因此，我们旨在测试HLA B27与慢性滑膜炎之间是否存在关联。我们使用标准血清学技术和反向线带分析法，对473名重度血友病患者（其中33人患有慢性滑膜炎）和1175名健康对照者进行了研究。血友病合并慢性滑膜炎的患者中，64%（33人中的21人）HLA B27呈阳性，而重度血友病但无慢性滑膜炎的患者中这一比例为5%（440人中的23人）（优势比31.6 [95%可信区间9.28 - 39.38]，p<0.0001），健康对照者中的比例为9%（1175人中的100人）（18.81 [9.6 - 27.7]，p<0.0001）。我们得出结论，在印度重度血友病患者中，HLA B27与慢性滑膜炎之间存在强关联，对该人群进行筛查有助于并发症的治疗和预防。
