Cid M C, Ercilla G, Vilaseca J, Sanmarti R, Villalta J, Ingelmo M, Urbano-Marquez A
Department of Internal Medicine, Hospital Clínic i Provincial, Barcelona, Spain.
Arthritis Rheum. 1988 May;31(5):678-82. doi: 10.1002/art.1780310515.
HLA class II antigens were determined in 65 patients with biopsy-proven giant cell arteritis (GCA). An increase in DR4 antigen frequency was found in the patients (40%) compared with that in 200 healthy controls (20%) (Pcorr less than 0.05). DR4 was significantly more frequent in GCA patients with polymyalgia rheumatica (PMR) than in those without PMR (58.8% versus 19.3%) (P less than 0.005). HLA-DR4 frequency in GCA patients without PMR was similar to that in the control population (20%). Patients with severe, disabling PMR had DR4 more frequently (90%) than did those with moderate symptoms who required medical care because of cranial arteritis manifestations (41.6%) (P less than 0.05). We conclude that, in GCA patients, association with DR4 is mainly related to the manifestation of the disease as PMR. We discuss clinical and immunogenetic similarities between PMR and other DR4-associated rheumatic disorders. Common immunopathogenic mechanisms leading to clinical overlap among them are suggested.
对65例经活检证实为巨细胞动脉炎（GCA）的患者进行了HLA - II类抗原检测。与200名健康对照者（20%）相比，患者中DR4抗原频率增加（40%）（校正P值小于0.05）。与无风湿性多肌痛（PMR）的GCA患者相比，伴有PMR的GCA患者中DR4的频率显著更高（58.8%对19.3%）（P小于0.005）。无PMR的GCA患者的HLA - DR4频率与对照人群相似（20%）。重度、致残性PMR患者的DR4频率（90%）高于因颅动脉炎表现而需要医疗护理的中度症状患者（41.6%）（P小于0.05）。我们得出结论，在GCA患者中，与DR4的关联主要与疾病表现为PMR有关。我们讨论了PMR与其他DR4相关风湿性疾病之间的临床和免疫遗传学相似性。提出了导致它们之间临床重叠的共同免疫致病机制。
