Summary
The association between HLA-A29 and birdshot chorioretinopathy is the strongest of all associations between HLA and disease. Determination of HLA-A29 is even of diagnostic significance. The association between HLA-B27 and acute anterior uveitis (AAU) is much weaker, but B27 positive AAU may be considered as a distinct clinical entity. B27 positive patients with AAU should be referred to a rheumatologist, because half of these patients have ankylosing spondylitis or Reiter's syndrome. The determination of HLA-Bw51 is of limited but significant diagnostic value for the diagnosis of Behçet's disease.
The present article shows how HLA determinations can serve as diagnostic tests. It is explained how the sensitivity and specificity of such tests can be used to calculate the influence of positive or negative results on the probability of the diagnosis.
The structure and function of HLA class I molecules is now known to a great extent. This may lead to a better understanding of the pathogenic role of HLA-A29, HLA-B27, HLA-Bw51 and other HLA molecules which are associated with uveitis.
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Abbreviations
- HLA:
-
human leucocyte antigen
- AAU:
-
acute anterior uveitis
- RR:
-
relative risk
References
Feltkamp TEW. Immunogenetic aspects of uveitis. In: Farraz LN, de Oliviera LN, eds. Ophthalmology today. Exerpta Medica, Int Congr Series 1988; 803: 27–36.
Feltkamp TEW. HLA and eye diseases. J Head and Neck pathol, 1990; 9: 21–26.
Derhaag PJFM, Feltkamp TEW. Acute anterior uveitis and HLA-327. Int Ophthalmol, 1990; 14: 19–23.
Bjorkman PJ, Saper MA, Samroni B, Bennett WS, Strominger JL, Wiley DC. Structure of the human class I histocompatibility antigen HLA-A2. Nature 1987; 329: 506–512.
Priem HA, Kijlstra A, Nones L, Baarsma GS, De Laey JJ, Oosterhuis JA. HLA typing in birdshot chorioretinopathy. Am J Ophthalmol 1988; 105: 182–185.
Sackett, Haynes, Tugwell, eds. Clinical epidemiology. Boston, Little Brown and Cie, 1985.
Suchman AL, Dolan JG. Odds and likelihood ratios. In: Clinical diagnosis and the laboratory (P.F. Grimer, R.J. Panzer and P. Greenland eds) Medical Publishers, Chicago, 1986; pp 36–43.
Rothova A, Van Veenendaal WG, Linssen A, Glasius E, Kijlstra A, de Jong PTVM. Clinical features of acute anterior uveitis. Am J Ophthalmol 1987; 103: 137–145.
Linssen A, Dekker-Saeys AJ, Dijkstra PF, Rothova A, Kruit PJ, Bakker M, Kijlstra A, Feltkamp TEW. The use of HLA-B27 as a diagnostic and prognostic aid in acute anterior uveitis (AAU) in the Netherlands. Doc Ophthalmol 1987; 64: 217–223.
Linssen A, Feltkamp TEW. B27 positive diseases versus B27 negative diseases. Ann Rheum Dis 1988; 47: 431–439.
Fagan TJ. Nomogram for Bayes's Theorem. N Engl J Med 1975; 293: 257.
Derhaag PJFM, Linssen A, Broekema N, de Waal LP, Feltkamp TEW. A family study of the inheritance of HLA-B27 positive acute anterior uveitis. Am J Ophthalmol 1988; 105: 603–606.
Derhaag PJFM, Linssen A, de Waal LP, Feltkamp TEW. HLA-B27 subtypes and acute anterior uveitis. Invest Ophthalmol Vis Sci 1988; 29: 1137–1140.
Derhaag PJFM, van der Horst AJ, de Waal LP, Feltkamp TEW. HLA-B27+ acute anterior uveitis and other antigens of the major histocompatibility complex. Invest Opthalmol Vis Sci, 1989; 30: 2160–2164.
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Feltkamp, T.E.W. HLA and uveitis. Int Ophthalmol 14, 327–333 (1990). https://doi.org/10.1007/BF00163552
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DOI: https://doi.org/10.1007/BF00163552