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Abstract Number: 2385

Prognostic Impact of HLA-B*51 and HLA–A*26:01 On Ocular Behcet’s Disease

Jun Won Park1, Eun Ha Kang2, Hye Won Kim1, Chaerin Park3, Hyeong Gon Yu3, Eun Young Lee1, Yun Jong Lee4, Eun Bong Lee1 and Yeong Wook Song5, 1Internal Medicine, Seoul National University Hospital, Seoul, South Korea, 2Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea, 3Ophthalmology, Seoul National University Hospital, Seoul, South Korea, 4Division of Rheumatology, Department of Internal Medicine, Rheumatology, Seoul National University, Seoul, South Korea, 5Division of Rheumatology, Department of Internal Medicine, Seoul National University, Seoul, South Korea

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Behcet's syndrome

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Session Information

Session Title: Vasculitis

Session Type: Abstract Submissions (ACR)

Background/Purpose: To investigate the prognostic implication of HLA-B*51 and HLA-A*26:01on visual outcome in Korean Behcet’s disease (BD) patients with uveitis.

Methods: Seventy-seven Korean BD patients with uveitis (F:M=29;48) who met the classification criteria by the International Study Group were enrolled. The presence of HLA-B*51 was determined by polymerase chain reaction (PCR) using sequence specific primers. Genotyping for HLA-Alocus was performed with PCR-Luminex typing method. Patient visual acuity (VA) was measured using Snellen chart at every visit to ophthalmology clinic. Loss of useful vision (LUV) was defined as VA worse than 20/200 for more than 6 months and near blindness (NB) was defined as VA of light perception or worse.        

Results: The onset of uveitis was 36.6 ± 10.8 (mean ± standard deviation) years of age and the duration of uveitis was 10.8 ± 7.2 years. Posterior uveitis was found in 64.9% (50/77) of patients. Forty-seven (61.0%) patients were treated with one or more systemic immunosuppressants other than steroids; azathioprine (n=38), cyclosporine (n=24), methotrexate (n=7), mycophenolate mofetil (n=7), cyclophosphamide (n=6), tacrolimus (n=2), or anti-TNF-a agents (n=2). HLA-B*51 was positive in 44.2% (34/77) while HLA-A*26:01 in 18.2% (14/77) of patients. In multivariate analyses, LUV was associated with male gender (p=0.032), duration of uveitis (p = 0.016), and posterior uveitis (p=0.010). HLA-A*26:01 was not directly associated with LUV but with posterior involvement (p<0.001). HLA-B*51 did not show any significant associations with LUV or posterior involvement. NB was associated with duration of uveitis (p=0.022) and glaucoma (p=0.026) in multivariate analysis. When patients with posterior uveitis were analyzed, the single most important factor for LUV was duration of uveitis (p=0.036) in multivariate analysis. NB in posterior uveitis patients was associated with the presence of HLA-B*51 (p = 0.025 in univariate analysis, p=0.062 in multivariate analysis).

Conclusion: HLA-A*26:01 was found to be associated with posterior involvement of uveitis in BD patients while HLA-B*51 tended to be associated with NB in those who develop posterior uveitis.


Disclosure:

J. W. Park,
None;

E. H. Kang,
None;

H. W. Kim,
None;

C. Park,
None;

H. G. Yu,
None;

E. Y. Lee,
None;

Y. J. Lee,
None;

E. B. Lee,
None;

Y. W. Song,
None.

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