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HLA antigens and adverse drug reactions to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis

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Summary

The association between HLA antigens and adverse drug reactions (ADR), (e.g. proteinuria, haematological abnormalities, stomatitis, diarrhoea and dermatitis) in rheumatoid arthritis (RA) to sodium aurothiomalate (gold) and to Dpenicillamine (PA) were studied in 32 patients. Thirtyeight RA patients treated with gold and PA, and with no ADR to these drugs, were used as controls. The frequency of HLA B8 was significantly (p<0.05) increased among RA patients with ADR compared to plasma donors. DR3 was also significantly increased (p<0.05) in RA patients with haematological ADR compared to plasma donors. Haematological ADR occured significantly (p<0.05) more often in DR3 positive patients (55%) than among DR3 negative RA patients (27%).

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References

  1. Schmidt, K.L., Mueller-Eckhardt, C. Agranulocytosis, levamisole and HLA-B27. Lancet, 1977, ii, 85.

    Google Scholar 

  2. Veys, E.M., Mielants, H., Rosenthal, M. Agranulocytosis, levamisole and HLA-B27. Lancet, 1977, ii, 764.

    Google Scholar 

  3. Panayi, G.S., Wooley, P., Batchelor, J.R Genetic basis of rheumatoid disease: HLA antigens, disease manifestations, and toxic reactions to drugs. Br Med J 1978, 2, 1326–1328.

    Google Scholar 

  4. Gran, J.T., Husby, G., Thorsby, E. HLA DR antigens and gold toxicity. Ann Rheum Dis, 1983, 42, 63–66.

    Google Scholar 

  5. Wooley, P.H., Griffin, J., Panayi, G.S., Batchelor, J.R., Welsh, K.I., Gibson, T.J. HLA DR antigens and toxic reaction to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis. N. Engl J Med, 1980, 303, 300–302.

    Google Scholar 

  6. Speerstra, F., Reekers, P., Putt, v.d. L.B., Vandenbroucke, J.P., Rasker, J.J., Rooy, d. J.R. HLA-DR antigens and proteinuria induced by aurothioglucose and D-penicillamine in patients with rheumatoid arthritis. J Rheumatol, 1983, 10, 948–953.

    Google Scholar 

  7. Bardin, T., Dryll, A., Debeyre, N., Rykewaert, A., Legrand, L., Marcelli, A., Dausset, J. HLA system and side effects of gold salts and D-penicillamine treatment of rheumatoid arthritis. Ann Rheum Dis, 1982, 41, 599–601.

    Google Scholar 

  8. Barger, B.O., Acton, R.T., Koopman, W.J., Alarcon, G.S. DR antigens and gold toxicity in white rheumatoid arthritis patients. Arthritis Rheum, 1984, 27, 601–605.

    Google Scholar 

  9. Bensen, W.G., Moore, N., Tugwell, P., D'Souza, M., Singal, D.P. HLA antigens and toxic reactions to sodium aurothiomalate in patients with rheumatoid arthritis. J Rheumatol, 1984, 11, 358–361.

    Google Scholar 

  10. Coblyn, J.S., Weinblatt, M., Holdsworth, D., Glass, D. Gold induced thrombocytopenia. Ann Intern Med, 1981, 95, 178–181.

    Google Scholar 

  11. Dequeker, J., van Wanghe, P., Verdickt, W. A systematic survey of HLA-A, B, C and D antigens and drug toxicity in rheumatoid arthritis. J Rheumatol, 1984, 11, 282–286.

    Google Scholar 

  12. Denman, E.J., Denman, A.M. The lymphocyte transformation test and gold hypersensitivity. Ann Rheum Dis, 1968, 27, 582–589.

    Google Scholar 

  13. Weizman, S.A., Stossel, T.P. Drug induced immunological neutropenia. Lancet, 1978, ii, 1068–1071.

    Google Scholar 

  14. Zilko, P.J., Dawkins, R.L. D-penicillamine — immunogenetics of effects and side effects. In: Immunogenetic in Rheumatology. Musculoskeletal Disease and D-penicillamine. Editors: Dawkins, R.L., Christiansen, F.T., Zilko, P.J. Excerpta Medica, Amsterdam, 1982, 280–375.

    Google Scholar 

  15. Ford, P.M. HLA antigens and drug toxicity in rheumatoid arthritis. J Rheumatol, 1984, 11, 259–361.

    Google Scholar 

  16. Bjelle, A., Cedergren, B., Rantapää Dahlqvist, S. HLA B27 in the population of Northern Sweden. Scand J Rheumatol, 1982, 11, 23–26.

    Google Scholar 

  17. Rantapää Dahlqvist, S., Ström, H., Bjelle, A., Möller, E. HLA antigens in RA — Clinical significance. (Submitted for publication).

  18. Rantapää Dahlqvist, S., Nordmark, L.G., Bjelle, A. HLA-B27 and involvement of sacroiliac joints in rheumatoid arthritis. J Rheumatol, 1984, 11, 27–32.

    Google Scholar 

  19. Ropes, M.W. Diagnostic criteria for rheumatoid arthritis. 1958 Revision. Ann Rheum Dis, 1959, 18, 49–50.

    Google Scholar 

  20. Latts, J.R., Antel, J.P., Levinson, D.J., Arnason, B.G.W., Medof, M.E. Histocompatibility antigens and gold toxicity: A preliminary report. J Clin Pharmacol, 1980, 20, 206–209.

    Google Scholar 

  21. Veys, E.M., Mielants, H., Verbruggen, G. Levamisole — induced adverse reactions in HLA B27 positive rheumatoid arthritis. Lancet, 1978, i, 148.

    Google Scholar 

  22. Karr, R.W., Rodey, G.E., Lee, T., Schwartz, B.D. Association of HLA-DRw4 wih rheumatoid arthritis in black and white patients. Arthritis Rheum, 1980, 23, 1241–1245.

    Google Scholar 

  23. Stastny, P. Joint report. Rheumatoid arthritis. In Histocompatibility testing, Editor: Terasaki, P.T., Los Angeles, UCLA Tissue typing Laboratory, 1980, 681–686.

    Google Scholar 

  24. Iveson, J.M., Scott, D.G., Persera, D.H., Cunliffe, W.J., Wright, V. Immunofluorescence of the skin in gold rashes — with particular reference to IgE. Ann Rheum Dis, 1977, 36, 520–523.

    Google Scholar 

  25. Luukkainen, R. Chrysotherapy in rheumatoid arthritis. Thesis University of Tampere. Scand J Rheumatol, 1980, (Suppl. 34).

  26. Skrifvars, B.V., Törnroth, T.S., Tallqvist, G.N. Gold-induced immune complex nephritis in seronegative rheumatoid arthritis. Ann Reum Dis, 1977, 36, 549–556.

    Google Scholar 

  27. Kean, W.F., Dwosh, I.L., Anastassiades, T.P., Ford, P.M., Kelly, H.G. The toxicity pattern of D-penicillamine therapy. Arthritis Rheum, 1980, 23, 158–164.

    Google Scholar 

  28. Bacon, P.A., Tribe, C.R., Mackenzie, J.C., Verrier Jones, J., Cumming, R.H., Amer, B. Penicillamine nephropathy in rheumatoid arthritis. Q J Med, 1976, 45, 661–684.

    Google Scholar 

  29. Jaffe, I.A., Tresher, G., Suzuki, Y., Ehrenreich, T. Nephropathy induced by D-penicillamine. Ann Intern Med, 1968, 69, 549–556.

    Google Scholar 

  30. Harth, M., Hickey, J.P., Coulter, W.K., Thompson, J.M., Disney T.F., Gold-induced thrombocytopenia. J Rheumatol. 1978, 5, 165–172.

    Google Scholar 

  31. Kay, A.G.L. Myelotoxicity of D-penicillamine. Ann. Rheum. Dis. 1979, 38, 232–236.

    Google Scholar 

  32. Munthe, E., Kåss, E. Penicillamine in rheumatic diseases: A prospective study of tolerance and efficacy. J. Rheumatol. 1981, (Suppl. 7), 8, 107–111.

    Google Scholar 

  33. Hansson, H., Möller, H. Patch test reactions to merthiolate in healthy young subjects. Br J Derm. 1979, 83, 349–356.

    Google Scholar 

  34. Howrie, D.L., Gartner, J.C.Jr. Gold-induced hepatotoxicity: case report and review of the literature. J Rheumatol, 1982, 9, 727–729.

    Google Scholar 

  35. Klouda, P.T., Manos, J., Acheson, E.J., Dyer, P.A., Goldby, F.S., Harris, R., Lawler, W., Mallick, N.P., Williams, G. Strong association between idiopathic membranous nephropathy and HLA-DRW3. Lancet, 1979, ii, 770–771.

    Google Scholar 

  36. Panayi, G.S. HLA antigens and adverse reactions to anti-rheumatic drugs. In: Modulation of Autoimmunity and Disease. Editor: Maini, R.N., Berry, H. Eastbourne, Praeger Publishers, 1981, 65–69.

    Google Scholar 

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Dahlqvist, S.R., Ström, H., Bjelle, A. et al. HLA antigens and adverse drug reactions to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis. Clin Rheumatol 4, 55–61 (1985). https://doi.org/10.1007/BF02032318

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  • DOI: https://doi.org/10.1007/BF02032318

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