Dados do Trabalho

Title

EVALUATION OF HLA B27 AS A SEVERITY FACTOR IN PATIENTS DIAGNOSED WITH SPONDILOARTRITES IN A REFERENCE AMBULATORY

Background

Spondyloarthritis (SpA) are a group of rheumatic diseases where inflammatory low back pain is a typical feature. There is an association with HLA-B27 and its role in disease severity is relevant to the early onset of axial involvement, severity and persistence of inflammation in sacroiliac and lumbar spine in addition to acute anterior uveitis. This study aims to analyze the statistical relevance between the presence of HLA-B27 and disease severity in patients with the various forms of spondylarthritis treated at a Rheumatology service.

Materials and methods

Retrospective, cross-sectional and descriptive study. Information was gathered by interviewing and analyzing patient records that obeyed the diagnostic criteria of SpA(modified New York criteria) and there was HLA-B27 result. Through the result, the population was sub-divided into SpA HLA-B27 positive patient and HLA-B27 negative patient for statistical analysis. . And compared through the evaluation instrument: ASDAS-VHS, ASDAS-PCR and joint and systemic disorders.

Results

55 patients diagnosed with SpA was included, mean age 48 years, most of them male (66%). Regarding the presence of the HLA-B27 gene: 36 (65.45%) negative and 19 (34.54%) positive. Regarding the activity measured by the ASDAS-VHS, 49.09% with high activity, while the ASDAS-PCR indicates the majority with moderate activity (33.72%). High and very high activities patients by ASDAS-VHS are higher in HLA-B27 positive patients: 52.6% and 15.8%, respectively, against 47.2% and 13.9% in negative patients. A similar statistical relevance was seen by the ASDAS-PCR, whose HLA-B27 positive patients with moderate activity in 36.8%, while the negative ones 30.6%. Regarding the clinical form, the axial involvement had a predominance of 28 patients (45.45%), which were 47.4% positive for HLA-B27 compared to 38.9% negative. In the evaluation of the history of acute anterior uveitis we found 9 (16.36%) patients, and only 2 with HLA-27 positive.

Conclusions

Summarizing, there is statistical relevance between patients positive for the HLA-B27 gene and the predominance of axial form and greater activity and severity of the disease, in agreement with the data of the literature, evaluated by the ASDAS-PCR and ASDAS-VHS disease activity instrument. And there isn’t a relevant statistics between history of acute anterior uveitis and HLA-B27 positive patients.