Rheumatology Book

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Major Histocompatibility Complex Antigens

Aka: Major Histocompatibility Complex Antigens, Human Leukocyte Antigen B27, HLA-B27
  1. Indications
    1. Limited use in clinical practice
    2. May be indicated if Ankylosing Spondylitis strongly suspected
  2. Labs: Methods of Testing
    1. Antibody binding to patient's cells
    2. Mixed Lymphocyte responses against specific targets
    3. Hybridization to DNA probes
  3. Efficacy
    1. Test Sensitivity for Spondyloarthropathy: 84%
    2. Test Specificity for Spondyloarthropathy: 96%
  4. Causes: Positive HLA-B27 (with Incidence)
    1. Ankylosing Spondylitis: 95%
    2. Reiter's Syndrome (Reactive Arthritis): 80%
    3. Psoriatic Arthritis (Spondylitis with Psoriasis): 70%
    4. Enteropathic Arthritis (Spondylitis with Inflammatory Bowel Disease): 50%
    5. Incidence in general population without disease: 6-8%
  5. References
    1. Gregersen in Ruddy (2001) Kelly's Rheumatology, p. 101
    2. Lane (2002) Am Fam Physician 65(6):1073-80
    3. Ali (2018) Am Fam Physician 98(3): 164-70 [PubMed]

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