@article{11182,
  keywords = {Adult, Aged, Arthritis, Rheumatoid, Felty Syndrome, Female, HLA-DR4 Antigen, Histocompatibility Antigens Class II, Humans, Male, Middle Aged, Vasculitis},
  author = {Westedt M L and Breedveld F C and Schreuder G M and D'Amaro J and Cats A and Vries R R},
  title = {Immunogenetic heterogeneity of rheumatoid arthritis.},
  abstract = {<p>Association of HLA-DR4/Dw4 with rheumatoid arthritis (RA) is well established, but conflicting data exist on a possible association with the severity of the disease, including its extra-articular manifestations. In order to investigate whether a subgroup of RA is preferentially associated with DR4, HLA typing was performed in two groups of patients with severe extra-articular manifestations (Felty's syndrome and histologically proved leucocytoclastic vasculitis), patients with severe joint destruction (seropositive and seronegative), a group with only mild joint destruction, and in healthy controls. The frequency of HLA-DR4 was significantly raised in all patient groups compared with that in healthy controls. The two groups with severe extra-articular manifestations, however, both had a DR4 frequency of 92%, which was significantly (p = 0.002) higher than the 62.7% found in the remaining patients. No significant differences were observed between severe or mild joint destruction and seropositivity or seronegativity in the groups without the above-mentioned extra-articular manifestations. From these data we concluded that DR4 is preferentially associated with severe extra-articular disease manifestations of RA. This observation provides an immunogenetic basis for the disease heterogeneity and for the immunological analogy between RA and leprosy.</p>},
  year = {1986},
  journal = {Annals of the rheumatic diseases},
  volume = {45},
  pages = {534-8},
  month = {1986 Jul},
  issn = {0003-4967},
  doi = {10.1136/ard.45.7.534},
  language = {eng},
}