Summary
An increase in the frequency of DR3 in rheumatoid arthritis (RA) patients exhibiting toxic reactions to gold salt (GS) therapy has been observed in several studies of Caucasoid patients. Likewise, the association of B35 with gold-induced mucocutaneous reactions has also been reported in Caucasoid RA patients. Similar studies in other ethnic groups have not been previously documented. The present study was performed in American black RA patients receiving GS to determine if there were similar HLA associations with toxic reactions as those reported in Caucasoids. Eighty-two seropositive and 18 seronegative American black RA patients were studied. Forty-one of the seropositive (50.0%) and six of the seronegative (33.3%) developed a toxic manifestation. No significant differences in the frequency distribution of HLA-B8, HLA-B35, DR, or DQw antigens were observed between the patients who had a toxic reaction and those who did not in either the seropositive or the seronegative RA patients. In particular, DR3 was not increased in patients with renal toxicity and B35 was not increased in patients with mucocutaneous reaction. Our study demonstrates that American black RA patients exhibiting GS toxicity do not have the same HLA associations as Caucasoids. The possibility that other genetic factor(s) may account for the occurrence of gold salt toxicity in American blacks requires further investigation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schmidt KL, Muller-Eckhardt C (1977) Agranulocytosis, levamisole and HLA-B27. Lancet II:85
Veys EM, Mielants H, Rosenthal M (1977) Agranulocytosis, levamisole and HLA-B27. Lancet II:764
Batchelor JR, Welsh KI, Tinoco RM, Dollery CT, Hughes GRV, Bernstein R, Ryan P, Naish PF, Aber GM, Bing RF, Russell GI (1980) Hydralazine-induced systemic lupus erythematosus: influence of HLA-DR and sex on susceptibility. Lancet II:1107–1109
Panayi GS, Wooley P, Batchelor JR (1978) Genetic basis of rheumatoid disease: HLA antigens, disease manifestation, and toxic reaction to drugs. Br Med J 2:1326–1328
Wooley PH, Griffin J, Panayi GS, Batchelor JR, Welsh KI, Gibson TJ (1980) HLA-DR antigens and toxic reaction to sodium aurothiomalate and D-penicillamine in patients with rheumatoid arthritis. N Engl J Med 303:300–302
Van Riel PLCM, Reekers P, Putte LBA van de, Gribnau FWJ (1983) Association of HLA antigens, toxic reactions and therapeutic response to auranofin and aurothioglucose in patients with rheumatoid arthritis. Tissue Antigens 22:194–199
Gran JT, Husby G, Thorsby E (1983) HLA-DR antigens and gold toxicity. Ann Rheum Dis 42:63–66
Coblyn JS, Weinblatt M, Holdsworth D, Glass D (1981) Gold-induced thrombocytopenia: a clinical and immunogenetic study of twenty-three patients. Ann Intern Med 95:178–181
Bensen WG, Moore N, Tugwell P, D'Souza M, Singal DP (1984) HLA antigens and toxic reactions to sodium aurothiomalate in patients with rheumatoid arthritis. J Rheumatol 11:358–361
Barger BO, Acton RT, Koopman WJ, Alarcón GS (1984) DR antigens and gold toxicity in white rheumatoid arthritis patients. Arthritis Rheum 27:601–605
Nusslein HG, Jahn H, Losh G, Guggenmoos-Holzmann I, Leibold W, Kalden JR (1984) Association of HLA-Bw35 with mucocutaneous lesions in rheumatoid arthritis patients under-going sodium aurothiomalate therapy. Arthritis Rheum 27:833–836
Alarcón GS, Koopman WJ, Acton RT, Barger BO (1985) HLA-Bw35 and gold toxicity in rheumatoid arthritis. Arthritis Rheum 28:236–237
Alarcón GS, Barger BO, Koopman WJ, Acton RT (1982) Seronegative rheumatoid arthritis: a distinct immunogenetic disease. Arthritis Rheum 25:502–507
Alarcón GS, Acton RT, Koopman WJ, Barger BO (1983) CREG antigens differentially influence expression of extra-articular manifestations in whites and blacks with rheumatoid arthritis. Semin Arthritis Rheum 13:169–173
Alarcón GS, Barger BO, Koopman WJ, Acton RT (1983) DR antigen distribution in blacks with rheumatoid arthritis. J Rheumatol 10:579–583
Ropes MW, Bennett GA, Cobb S, Jacox R, Jessar RA (1959) 1958 revision of diagnostic criteria for rheumatoid arthritis. Arthritis Rheum 2:16–20
Singer JM, Plotz CM (1956) The latex fixation test. I. Application to the serologic diagnosis of rheumatoid arthritis. Am J Med 21:888–892
Terasaki P, Bernoco D, Park MS, Ozturk C, Iwaki Y (1978) Microdroplet testing for HLA-A, -B, -C and -DR antigens. Am J Clin Pathol 69:103–120
Albert ED, Baur MP, Mayr WR (eds) (1984) Histocompatibility testing. Springer, Berlin Heidelberg New York Tokyo
Woolf B (1955) On estimating the relation between blood group and disease. Ann Hum Genet 19:251–253
Rodnan GP, Schumacher HR (1983) Rheumatoid arthritis. In: Primer on the rheumatic disease, 8th edn. Arthritis Foundation, Atlanta, Ga, pp 38–48
Gottlieb NL (1985) Gold compounds. In: Kelley WN, Harris ED Jr, Ruddy S, Sledge CB (eds) Textbook of rheumatology. Saunders, Philadelphia London Toronto Mexico City Rio de Janeiro Sidney Tokyo
Reitnauer PF, Go RCP, Acton RT, Murphy CC, Budowle B, Barger BO, Roseman JM (1982) Evidence for genetic admixture as a determinant in the occurrence of insulin dependent diabetes melitus in US Blacks. Diabetes 31:532–537
Workman PL, Blumberg BS, Cooper AL (1963) Selection, gene migration and polymorphic stability in a US Caucasoid and Negro population. Am J Hum Genet 115:429–437
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Alarcón, G.S., Barger, B.O., Acton, R.T. et al. HLA antigens and gold toxicity in American blacks with rheumatoid arthritis. Rheumatol Int 6, 13–17 (1986). https://doi.org/10.1007/BF00270659
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00270659