J Rheum Dis.  2018 Jan;25(1):58-64. 10.4078/jrd.2018.25.1.58.

Prevalence, Risk Factors, and Expression of Human Leukocyte Antigen-DRB1 in Juvenile Idiopathic Arthritis-associated Uveitis

• Pyo JK
• Lee S
• Kim KN

• KMID: 2405021
• DOI: http://doi.org/10.4078/jrd.2018.25.1.58

Abstract

OBJECTIVE
This study investigated the prevalence and risk factors of juvenile idiopathic arthritis (JIA)-associated uveitis (JIA-U) in a pediatric tertiary center in Korea. In addition, this study examined whether a specific HLA-DRB1 allele could be a predictive risk factor of uveitis in JIA.
METHODS
The pediatric rheumatology and ophthalmology medical records for JIA between March 2006 and March 2016 were analyzed retrospectively. A total of 233 were enrolled in this study.
RESULTS
Of 233 patients, 31 developed uveitis (13.3%): 14 oligoarticular, three polyarticular, six systemic, seven enthesitis-related, and one undifferentiated-type JIA. In oligoarticular JIA, 26.4% developed uveitis. The percentage of females with JIA-U was 54.8%, and the median age of the onset of JIA was 7.02 years in JIA-U. Antinuclear antibody (ANA) positivity in oligoarticular JIA-U was 57.1%. Of the 31 JIA-U cases, 26 (83.9%) were clinically asymptomatic when diagnosed. The allele frequency of HLA-DRB1*09 of the total JIA-U was higher than that of JIA without uveitis. HLA-DRB1*09 and HLA-DRB1*12 were higher in oligoarticular JIA-U than in JIA without uveitis.
CONCLUSION
Korean JIA-U has different features from JIA-U in Western countries. The sex ratio and age of JIA onset showed no significant differences in Korean JIA-U. The ANA positivity was more common in JIA-U than in JIA without uveitis only in oligoarticular type JIA. These differences might be due to genetic factors, particularly HLA-DRB1. These results suggest HLA-DRB1*09 and HLA-DRB1*12 in oligoarticular JIA to be risk factors for JIA-U in Korea. This is the first study to analyze the association between HLA-DRB1 and JIA-U in Korea.

Keyword

Juvenile idiopathic arthritis; Uveitis; Prevalence; Risk factor; HLA-DRB1

MeSH Terms

Alleles
Antibodies, Antinuclear
Arthritis, Juvenile
Female
Gene Frequency
HLA-DRB1 Chains
Humans*
Korea
Leukocytes*
Medical Records
Ophthalmology
Prevalence*
Retrospective Studies
Rheumatology
Risk Factors*
Sex Ratio
Uveitis*
Antibodies, Antinuclear
HLA-DRB1 Chains

Figure

• 

  Figure 1. Distribution of age at time of diagnosis of arthritis in 233 patients with juvenile idiopathic arthritis (JIA).

• 

  Figure 2. Human leukocyte antigen (HLA)-DRB1 phenotype frequencies in juvenile idiopathic arthritis-associated uveitis (JIA-U) and juvenile idiopathic arthritis (JIA) without uveitis. *p-value＜0.05.

• 

  Figure 3. Human leukocyte antigen (HLA)-DRB1 phenotype frequencies of oligoarticular juvenile idiopathic arthritis (JIA) in juvenile idiopathic arthritis-associated uveitis (JIA-U) and JIA without uveitis. *p-value＜0.05.

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