Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Division of Hematology, Rheumatology and Respiratory Medicine Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Mod Rheumatol. 2023 Mar 2;33(2):392-397. doi: 10.1093/mr/roac008.
Due to the low prevalence of HLA-B27 and ankylosing spondylitis (AS) in Japan, rheumatologists have little experience with AS. We conducted a multicentre study to identify the characteristics and frequency of HLA-B types.
We analysed epidemiological and clinical data, blood tests, spine radiographs, and HLA-B types in Japanese AS patients.
We evaluated 111 AS patients, predominantly men (82.9%). The mean age, disease onset, diagnosis, and time from onset to diagnosis were 43.7, 24.2, 36.0, and 11.6 years, respectively. Inflammatory low back pain was found in 96 cases (86.5%); peripheral arthritis in 59 (53.2%), enthesitis in 35 (31.5%), and dactylitis in 6 (5.4%). Extra-articular symptoms included uveitis, psoriasis, and inflammatory bowel disease in 41 (36.9%), 1 (0.9%), and 5 (4.5%) cases, respectively. HLA-B27 was positive in 83 cases (74.8%; odds ratio, 1146.0); and HLA-B48 in 9 (8.1%; odds ratio, 3.0). HLA-B27-positive patients were younger at onset and had a shorter diagnostic delay.
AS clinical symptoms were almost the same as other countries except for the low coexistence of psoriasis. HLA-B27 positivity in Japanese patients was 78%. HLA-B27-positive patients were younger and diagnosed earlier. In addition to HLA-B27, a relationship with HLA-B48 was suggested.
由于 HLA-B27 和强直性脊柱炎 (AS) 在日本的发病率较低，风湿病医生对此类疾病的诊治经验有限。本研究旨在多中心分析日本 AS 患者的 HLA-B 类型特征及分布频率。
分析日本 AS 患者的流行病学、临床及实验室数据、脊柱 X 线片和 HLA-B 类型。
共评估了 111 例 AS 患者，以男性为主（82.9%）。患者的平均年龄、发病年龄、确诊年龄、发病至确诊时间分别为 43.7 岁、24.2 岁、36.0 岁和 11.6 年。96 例（86.5%）存在炎性下腰痛，59 例（53.2%）存在外周关节炎，35 例（31.5%）存在肌腱端炎，6 例（5.4%）存在指（趾）炎。41 例（36.9%）存在关节外表现，包括葡萄膜炎、银屑病和炎症性肠病；1 例（0.9%）存在银屑病；5 例（4.5%）存在炎症性肠病。83 例（74.8%）HLA-B27 阳性，9 例（8.1%）HLA-B48 阳性。HLA-B27 阳性患者的发病年龄更小，确诊时间更早。
除银屑病发生率较低外，日本 AS 患者的临床表现与其他国家相似。日本 AS 患者 HLA-B27 阳性率为 78%。HLA-B27 阳性患者发病年龄更小，确诊时间更早。除 HLA-B27 外，HLA-B48 可能也与 AS 相关。
