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E. González-Rubio, M. Pedroza-Seres, S. Voorduin-Ramos; Clinical Differences Between Patients With Acute Anterior Uveitis HLA-B27 Positive and HLA-B27 Negative. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3889.
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Anterior idiophatic uveitis are the most frequent diagnosis in uveitis patients followed by those associated to haplotype HLA-B27 with or without association to seronegative spondyloarthropathies. There are not clinical studies in Mexican population with uveitis associated to the haplotype HLA-B27.To determine the clinical differences in patients with non-granulomatous acute anterior uveitis (AAU) associated to HLA-B27 positive antigen and HLA-B27 negative. Desing of the study: Longitudinal, observational, cases and controls.
Records of patients with diagnosis of AAU of the Uvea Department at the Institute of Ophthalmology were included. Variables We considered the following variables: complete medical history, age, age at onset of uveitis, gender, evolution time, seronegative spondyloarthropathies associated, HLA-B27, visual capacity, intraocular pressure, number of recurrences, eye involved, grading of inflammatory reaction in the anterior chamber, presence of synechias, posterior segment manifestations and complications. Statistical Analysis: Percentages differences were compared with X2 test. Means differences were analysed by t of Student test.
A total of 80 patients with AAU were included, 40 HLA-B27 positive and 40 HLA-B27 negative. There was not statistically significant differences in: age, sex, age at onset of uveitis, family history of articular illnesses and visual capacity. The time of evolution average was higher in the group HLA-B27 positive (3.6 years) compared to HLA-B27 negative group (1.13 years) (p=0.001). Patients with AAU associated to HLA-B27 haplotype presented more frequency of seronegative spondyloarthropaties (30%); compared to HLA-B27 negative (5%) (p=0.006). Ankylosing spondylitis was more frequent 9 (22.5%), followed by psoriatic arthritis 2 (16.7%), CUCI 1 (8.3%). In HLA-B27 negative group 5% had associated illness. The average of recurrences in HLA-B27 positive group were 2.95 (s.d. 3.33) compared to 1.95 recurrences (s.d. 1.8) in the HLA-B27 negative group. Patients from the HLA-B27 positive group presented more severe inflammation (62.8%) compared to HLA-B27 negative group (p=0.024). Posterior uveitis manifestations were higher (72.7%) in HLA-B27 positive patients as well as complications compared to HLA-B27 negative patients.
AAU associated to HLA-B27 positive haplotype in our population showed similar behavior as reported in other studies.
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