HLA B27 AND RESPIRATORY INVOLVEMENT IN AXIAL SPONDYLARTHROPATHIES - ARETROSPECTIVE STUDY IN 107 MALE-PATIENTS

Objective. To conduct a retrospective study of respiratory involvement in axial spondylarthropathies according to HLA B27 status. Method. Sc hober's index, chest expansion and lung function parameters were measu red in 107 male inpatients with spondylarthropathies, including 78 wit h and 29 without the HLA B27 antigen (groups I and II, respectively). Active or severe spondylarthropathy was defined based on widely used c linical and laboratory test parameters. Results. The two groups were s imilar regarding age, body mass index, disease duration, proportion of smokers and proportion of patients requiring nonsteroidal antiinflamm atory drug therapy. Overall, 30 patients had pure active disease, 11 h ad pure severe disease, 26 had active severe disease and 40 had nonact ive nonsevere disease. Group I patients were significantly more likely to have active severe disease than group II patients, whereas the opp osite was true for nonactive nonsevere disease. Mean erythrocyte sedim entation rate was higher in group I (22.6 +/- 21.6) than in group II ( 13.3 +/- 12.5) (P = 0.039), Group I patients had lower values for ches t expansion (5.4 +/- 2.2 cm versus 6.37 +/- 1.9 cm; P = 0.045), vital capacity (91.9% +/- 13.9% versus 99.5% +/- 17.6%; P = 0.021), and tota l capacity (91.8 +/- 12.3 versus 98.1 +/- 13.9; P = 0.025). A restrict ive defect was found in 12 group I patients versus one group II patien t (nonsignificant difference). All patients with restrictive defects h ad active and/or severe disease. Two-way analysis of variance and Fish er's PSLD post-test suggested that lung function was influenced by dis ease severity but not by disease activity. Conclusion. Lung function i mpairment may be more common and more severe in HLA B27-positive than in HLA B27-negative spondylarthropathy patients. This difference may b e entirely ascribable to increased disease severity in HLA B27-positiv e patients.