Dequeker J, Van Wanghe P, Verdickt W
J Rheumatol. 1984 Jun;11(3):282-6.
One hundred sixty-two consecutive patients with rheumatoid arthritis (RA) were studied for possible association between HLA antigens, particularly DR antigens, and disease characteristics and adverse reactions to gold or D-penicillamine treatment. The frequency of HLA-DR4 was significantly increased: 62% in RA compared to 23% in controls. An association of HLA-DR4 with a positive family history for RA was also found. HLA-DR4 was not associated with subcutaneous nodules or keratoconjunctivitis, presence of rheumatoid factor, or ANA positivity. No increased prevalence of HLA-DR3 was found in patients who developed drug related toxicity (e.g., proteinuria for gold or D-penicillamine). Of the 27 patients in whom proteinuria developed, only 5 were DR3 positive. A significant association with D-penicillamine induced proteinuria and HLA-B8 gene was found. Our results obtained in a systematic survey do not confirm previous reports of a significant association between HLA-DR3 and drug toxicity, but confirm the association between HLA-DR4 and the development of RA and HLA-B8 and D-penicillamine induced proteinuria.
对162例连续性类风湿关节炎（RA）患者进行了研究，以探讨HLA抗原，尤其是DR抗原与疾病特征以及对金制剂或青霉胺治疗的不良反应之间可能存在的关联。HLA - DR4的频率显著升高：RA患者中为62%，而对照组为23%。还发现HLA - DR4与RA的阳性家族史有关。HLA - DR4与皮下结节、角膜结膜炎、类风湿因子的存在或ANA阳性无关。在发生药物相关毒性（如金制剂或青霉胺所致蛋白尿）的患者中，未发现HLA - DR3患病率增加。在出现蛋白尿的27例患者中，只有5例为DR3阳性。发现与青霉胺诱导的蛋白尿和HLA - B8基因存在显著关联。我们在系统调查中获得的结果并未证实先前关于HLA - DR3与药物毒性之间存在显著关联的报道，但证实了HLA - DR4与RA发病之间以及HLA - B8与青霉胺诱导的蛋白尿之间的关联。
