Destructive arthritis, rheumatoid factor, and HLA-DR4. Susceptibility versus severity, a case-control study.

摘要: In response to the continuing debate as whether seronegative rheumatoid arthritis (RA) and seropositive RA are part of same disease spectrum or distinct disorders, we evaluated 720 patients with definite classic RA, whom 53 subjects had persistently destructive disease. For all but 1 patient, a case control was identified matched for age, duration, degree destruction on hand radiographs, disease-modifying drug therapy. DR typing undertaken these 105 patients, together scoring radiographs. The frequency DR4 69% in 60% (P = 0.22), versus 36% 318 healthy controls 0.008 P 0.007 respectively). Patients were rematched different series subanalyses order make comparisons radiograph scores. We found that HLA-DR4 associated both patients. general, DR4+ more severe by radiologic criteria than did DR4- Thus, may be an additive factor serologic status closely related severity susceptibility.