Petty R E
Department of Pediatrics, University of British Columbia, Vancouver.
J Rheumatol Suppl. 1990 Nov;26:7-10.
In childhood, the histocompatibility antigen HLA-B27 is associated with juvenile ankylosing spondylitis, Reiter's syndrome, and the sacroiliitis of juvenile psoriatic arthritis, and inflammatory bowel diseases. The low frequency of signs or symptoms of spine or sacroiliac joint disease at onset differentiate these disorders from their adult counterparts and make early diagnosis difficult. The presence of enthesitis and the absence of rheumatoid factor and antinuclear antibody suggests the diagnosis of one of the seronegative spondyloarthropathies. The mechanisms by which HLA-B27 positivity confers susceptibility to disease are uncertain. To date, no genetically determined differences in the HLA-B27 molecule, or in the T cell receptor which recognizes antigen in the context of HLA-B27, have been consistently shown to be associated with the presence of disease. There is no explanation for the onset of disease in childhood in some individuals.
在儿童期，组织相容性抗原HLA - B27与青少年强直性脊柱炎、赖特综合征、青少年银屑病关节炎的骶髂关节炎以及炎性肠病相关。发病时脊柱或骶髂关节疾病体征或症状的低发生率使这些疾病有别于成人同类疾病，且早期诊断困难。附着点炎的存在以及类风湿因子和抗核抗体的缺乏提示血清阴性脊柱关节病的诊断。HLA - B27阳性导致易患疾病的机制尚不清楚。迄今为止，尚未一致证明HLA - B27分子或在HLA - B27背景下识别抗原的T细胞受体存在基因决定的差异与疾病的存在相关。对于某些个体在儿童期发病的原因尚无解释。
