POSTSTREPTOCOCCAL REACTIVE ARTHRITIS - CLINICAL CHARACTERISTICS AND ASSOCIATION WITH HLA-DR ALLELES

Objective. To assess the relationship of poststreptococcal reactive ar thritis (ReA) to other forms of ReA and rheumatic fever by comparing t he frequency of HLA-B27 and DRB1 alleles in these diseases. Methods. T he diagnosis of poststreptococcal ReA was established in 25 children s een in a pediatric rheumatology clinic. HLA-B27 and DRB1 genotyping wa s performed in 18 of the white American patients. The DRB1 genotyping results were compared with those in 33 patients with rheumatic fever a nd 190 normal individuals, Results. HLA-B27 was positive in 3 of the 1 8 poststreptococcal ReA patients, a frequency not different from that found in normal individuals. Compared with normal controls, the freque ncy of the DRB101 allele was higher in poststreptococcal ReA patients (odds ratio [OR] 2.7, P = 0.044), while DRB116 was increased in pati ents with rheumatic fever (OR 4.3, P = 0.028), Conclusion. The associa tion of poststreptococcal ReA with HLA-DRB1O1, but not with HLA-B27, suggests that its pathogenesis may be more similar to that of rheumati c fever than to that of ReA associated with enteric pathogens.