[Associations of HLA-DR 4, DR 2, DRw 9 with clinical findings in rheumatoid arthritis].

HLA-DR antigens were determined in 128 patients with classical or definite rheumatoid arthritis (RA) according to American Rheumatism Association criteria (1957). HLA-DR 4 was significantly (p less than 0.01) increased in patients with RA (60%) compared with Japanese control (40%). In radiological changes, the frequency of stage II to IV were significantly greater in DR 4 positive patients (87.1% (67/77)) than in negative patients (70.6%) (36/51)). An early onset of disease was significantly (p less than 0.05) associated with DR 4 positive patients with duration of 4 years or more. Erythrocyte sedimentation rate was significantly (p less than 0.05) less in DR 2 positive patients (8.0% +/- 8.6 (39)) than DR 2 negative patients (12.2 +/- 11.9 (84)). Frequency of Sjogren's syndrome was more in DR 2 positive patients (41.3% (12/29)) than in DR 2 negative (29.2% (19/65)), and less in DR 4 positive (25.4% (15/59)) than in DR 4 negative (45.7% (16/35)), so the complication of Sjogren's syndrome showed a trend against the severity of RA. There were no associations between rheumatoid factor and HLA-DR phenotypes, but the frequency of anti-nuclear anti-nuclear antibody was significantly (p less than 0.01) lower in DRw 9 positive patients (38.4% (15/39)) than in DRw 9 negative (62.7% (54/86)). In both DR 4 and DRw 9 positive patients (16 cases), onset of disease (38.9 years-old +/- 15.9 (16)) was significantly earlier and frequency of Sjogren's syndrome (10.0% (1/10)) was significantly lower than those in DR 4 negative patients (48.5 years-old +/- 12.5 (51): 45.7% (15/35) respectively). The frequency of HLA-DRw 9 was greater in Japanese than people in the other countries and there was the close association between pathogenesis of RA and HLA-DRw 9 as well as DR 4 and DR 2 in Japan.