ASSOCIATION OF INTERMEDIATE UVEITIS WITH HLA-A28 - DEFINITION OF A NEW SYSTEMIC SYNDROME

Background: Endogenous posterior uveitis (PU) can be associated with s ystemic diseases, and certain forms have strong association with HLA a ntigens. Much less is known regarding intermediate uveitis (IU). The p urpose of this study was to determine whether IU is associated with th e HLA system and whether it can be associated with systemic symptoms. Methods: In 179 consecutive patients consulting for uveitis, a detaile d history was obtained and a physical examination performed. HLA typin g for 71 HLA-A, B, DR and DQ antigens, laboratory tests, and radiograp hy of the chest, sinuses, and sacroiliac joints were systematically pe rformed. Results: Thirty-two patients (18%) had IU; 51(28.5%) had PU a nd constituted our internal control group. Nine of the patients with I U (28%) had the HLA-A28 antigen, compared with 8.1% of a healthy contr ol population and 8.6% of the patients with PU (P < 0.001). An associa ted disease was found in four patients with IU (12.5%) (none was HLA-A 28) and in 45% of the patients with PU (P < 0.01). Some 67% of HLA-A28 patients with IU had arthralgias affecting the kneels), compared with 17% of non-HLA-A28 patients and 18% of patients with PU (P < 0.05 and P < 0.01 respectively); 55% had gonalgias and hypocomplementemia comp ared with 9% and 2% respectively (P < 0.01 and P < 0.001). Conclusions : IU is significantly associated with HLA-A28; patients having this an tigen may represent a subset of the disease characterized by an increa sed prevalence of arthralgias and hypocomplementemia.