Human Leukocyte Antigen-B In Patients with Psoriasis and Psoriatic Arthritis

Abstract

Certain Human leukocyte antigen (HLA) is associated with the development of psoriasis and psoriatic arthritis. Asymmetric oligoarthritis is one of the presentation of psoriatic arthritis. We aimed to evaluate the asymmetry of joint involvement with respect to HLA-B by ultrasound. Fifty-five patients with psoriatic arthritis (PsA) and psoriasis (PsO) were evaluated on their IPs, PIPs, DIPs, MCPs, wrists, elbows, shoulders, acromioclavicular joints, sternoclavicular joints, knees, ankles, MTPs. Joint inflammation was assessed by ultrasound and graded 0-3 upon grey scale and power doppler. Human leukocyte antigen B results were reviewed retrospectively. After excluding joints with symmetric normal presentation upon sonography, we analyzed the asymmetry of joint inflammation with categorical data. Right third DIP and left second MTP were affected more than their fellow ones (McNemar test, p=0.049 and p=0.039 respectively). HLA-B60, HLA-B46, HLA-B58, HLA-B27, HLA-B38, HLA-B39 were most frequently observed. Presence of the above-mentioned HLA-B alleles were distributed between PsA and PsO without significant difference and did not affect the distribution of the involved joints. After converting to continuous variables and considering normal symmetric joints, right third DIP and left second MTP joints remained (Wilcoxon signed-rank test, p=0.041, p<0.001 respectively). Right second DIP was affected more than the left in patients positive for HLA-B60 or B61. Left fourth MCP affected more than the fellow one in positive HLA-B27. Left second PIP in positive HLA-B38 or HLA-B39. Joint sonography can be useful in different HLA-B alleles in PsA and PsO patients.