HLA antigens in patients with giant cell arteritis, compared with two control groups of different ages

HLA antigens in polymyalgia rheumatica in northern Sweden

The HLA-A, B and DR antigens were analyzed with serological methods in 75 patients with polymyalgia rheumatica (PMR). In PMR patients the frequency of the HLA-DR4 antigen was significantly higher (62.1%) compared to blood donors (40%), p < 0.05, but did not differ from patients with seropositive rheumatoid arthritis (RA) from the same area (63.1%). In contrast, the frequency of HLA-B27 in the PMR patients (9.3%) was significantly lower compared to RA (27.2%), p < 0.01, but did not differ from blood donors (16.9%). There was no association between DR4 and disease affliction or severity in PMR. The increased frequency of HLA-B27 in RA but not in PMR in the population of northern Sweden suggests an immunogenetic difference between these two HLA-DR4 associated diseases.

Polymyalgia rheumatica and temporal arteritis

Polymyalgia rheumatica and temporal arteritis are a clinical syndrome and clinicopathologic entity, respectively. Polymyalgia rheumatica occurs more commonly than temporal arteritis, with approximately half of all patients with temporal arteritis having the polymyalgia rheumatica syndrome. Both conditions are found in the population over 50 years of age and are associated with an elevated ESR. The etiology of both is unclear, although genetic, and potentially, environmental factors may play significant roles. Both conditions respond to corticosteroid therapy, but patients with temporal arteritis require significantly higher doses to control symptoms and to prevent blindness.

Association between giant cell (temporal) arteritis and HLA-Cw3

Thirty-five Caucasian patients with giant cell (temporal) arteritis were typed for HLA class I and II antigens. A significant increase was found for A31, B40, Cw3, and DR4. HLA-Cw3 was the most frequent antigen observed (57%) and had the highest relative risk (5.65), suggesting that Cw3 may be the primary HLA risk factor for this disease. The increased occurrence of A31, B40, and DR4 is probably secondary to their association with Cw3.

HLA DR4 and giant cell arteritis

We reported the data of HLA-DR frequencies in a new series of 40 unrelated patients suffering from giant cells arteritis (Horton's disease). As previously reported by us, a large increase of HLA-DR4 antigen frequency is noted in patients compared with 146 healthy controls. Moreover, gathering together these 40 patients with the 48 other patients of our first published data, increase of the DR4 frequency is largely confirmed with a Pc less than 0.001.

The epidemiology of giant cell arteritis. Report of a ten-year study in Shelby County, Tennessee

We have studied the epidemiology of giant cell arteritis (GCA) in an urban population in south central United States. The incidence of GCA in Shelby County, Tennessee for the years 1971 through 1980 was determined for the total population and for age-, sex-, and race-specific groups. Over this period 26 cases were identified. The average annual incidence was 0.35/100,000. This was increased to 1.58/100,000 for those over the age of 50. The incidence was 7 times greater in whites than in blacks and 7 times greater in females than in males. Clinical and laboratory features of the patients were reviewed and found to be similar to those in other populations. GCA is considerably less frequent in Shelby County, Tennessee than in other areas where similar epidemiologic studies have been performed. This difference can be accounted for only in part by racial distributions. Similar studies in southern geographic areas are needed to place our findings in perspective and point to specific factors which may have etiologic significance in GCA.

Serologic and immunopathologic findings in temporal arteritis

In 104 patients undergoing biopsies for temporal arteritis, lymphocyte characterization identified both T4 helper/inducer and T8 cytotoxic/suppressor lymphocytes in approximately equal numbers. B lymphocytes were absent. Deposition of IgM and IgG was observed in three of 16 positive biopsy specimens. Antinuclear antibodies were present in ten of 16 biopsy-proven cases of temporal arteritis compared with 19 of 55 in the control group with negative biopsy specimens. Anti-smooth-muscle, anti-DNA, and antimitochondrial antibodies were not useful in distinguishing between the two groups.