HLA-B27

HLA-B27 (human leukocyte antigens) is a gene marker that can occur in diseases that belong to the group of seronegative spondyloarthritides (inflammation of the vertebral joints) (lack of rheumatoid factor; usually lack of rheumatoid nodules; preferentially sacroiliitis/inflammatory change of the lower spine; this includes joints between the sacrum and ilium, sacroiliac joints). These include:

  • Bechterew’s disease (ankylosing spondylitis) – chronic inflammatory rheumatic disease that affects only the spine and its border joints.
  • Psoriatic arthropathy (synonym: psoriatic arthritis) – joint complaints that can occur in the context of psoriasis.
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
  • Uveitis anterior – inflammation of the anterior region of the uvea (middle eye skin), especially the iris (iris) and the ciliary muscle.

The procedure

Material needed

  • EDTA blood

Preparation of the patient

  • Not necessary

Disruptive factors

  • Not known

Indications

  • Suspicion of seronegative spondyloarthritides.

Interpretation

Interpretation of HLA-B27 positive findings.

Other notes

  • As a basic diagnostic test, the following laboratory tests should be performed when rheumatoid arthritis is suspected.
    • CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
    • Rheumatoid factor (or CCP-AK)
    • ANA (antinuclear antibodies)
    • HLA-B27 (Histocompatibility antigens).
  • If seronegative spondyloarthritides are suspected, the following laboratory tests should be performed:
    • HLA-B27
    • Arthritis pathogen