Sugimoto H, Shinozaki T, Ohsawa T, Kamata K, Ohkubo A, Ohhara K
Department of Radiology, Jichi Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1993 Apr 25;53(4):387-94.
Six cases of ankylosing spondylitis (AS) complicated with acute anterior uveitis (AAU) were reviewed. Clinical and radiologic findings of these cases were correlated with HLA-B27. All the patients were men; four of them were HLA-B27 positive, and two were B27 negative. The average age of onset was younger in B27+ patients than in B27- patients. Ophthalmologic study showed no definite difference in inflammatory change of AAU between B27+ patients and B27- patients. AAU in B27+ patients was completely cured in three months. A history of low back pain was more apparent in B27+ than in B27- patients. Three out of four B27+ patients showed complete bony ankylosis in sacroiliac joints, whereas no ankylosis was seen in B27- patients. CT scan was useful to demonstrate sacroilitis in cases with equivocal radiologic findings. Spondylitic changes were more extensive in B27+ than in B27- patients. The results support the concept that HLA-B27+ AS and B27- AS are different entities with similar phenotypic expression, and HLA-B27 is an arthritogenic gene in the Japanese population as well.
回顾了6例强直性脊柱炎（AS）合并急性前葡萄膜炎（AAU）的病例。将这些病例的临床和放射学表现与HLA - B27进行了相关性分析。所有患者均为男性；其中4例HLA - B27阳性，2例B27阴性。B27阳性患者的平均发病年龄比B27阴性患者年轻。眼科研究显示，B27阳性患者和B27阴性患者的AAU炎症变化无明显差异。B27阳性患者的AAU在三个月内完全治愈。B27阳性患者的腰痛病史比B27阴性患者更明显。4例B27阳性患者中有3例骶髂关节出现完全性骨强直，而B27阴性患者未见骨强直。对于放射学表现不明确的病例，CT扫描有助于显示骶髂关节炎。B27阳性患者的脊柱病变比B27阴性患者更广泛。结果支持以下观点：HLA - B27阳性AS和B27阴性AS是具有相似表型表达的不同实体，并且在日本人群中HLA - B27也是一个致关节炎基因。
