HLA and Juvenile Chronic Polyarthritis

Abstract

HL-A antigens were identified in patients with juvenile chronic polyarthritis (JCP) (n = 35). In JCP the incidence of antigen B27 (57%) was higher than in a normal population (n = 1000). On recent evaluation of the clinical status, serology and X-rays, the patients with JCP who were followed for many years, could be subdivided into 4 groups: group 1, JCP evolving to ankylosing spondylitis (n = 3); group 2, JCP with sacroileitis (n = 17); group 3, JCP without sacroileitis (n = 9); group 4, juvenile rheumatoid arthritis characterized by a positive serology (n = 6). Groups 1 and 2 were characterized by a high incidence of antigen B27 (19/20). Only 1 subject of groups 3 and 4 had antigen B27. Sex distribution in groups 1 and 2 was similar to that found in ankylosing spondylitis in adults, and sex distribution in groups 3 and 4 was similar to that found in rheumatoid arthritis in adults. If B27 positives develop juvenile chronic polyarthritis they have a high risk of developing sacroileitis and acute uveitis. The name Still''s disease was used for the total group of children presenting initial symptoms corresponding to previous criteria. Follow-up of the cases permitted their further classification as juvenile ankylosing spondylitis, as JCP with or without sacroileitis or as juvenile rheumatoid arthritis.