HLA-DR TYPING AND DIFFERENT CLINICAL MANIFESTATIONS OF PAEDIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN A TERTIARY HOSPITAL, BANGLADESH

Susmita Das, Manik Kumar Talukder*, Md Imnul Islam, Shahana A. Rahman, Md. Mahbubul Islam, Rumana Riaaz

ABSTRACT

Introduction: Association of MHC (Major histocompatibility complex) with SLE is widely studied and it is evident that HLA class II genes are strongly associated with SLE. Among HLA-DR types, some alleles are considered as risk factors for certain clinical manifestations and some alleles may predict different organ involvement. Objective: To determine the association between HLA-DR typing with different clinical manifestations in paediatric SLE patients (pSLE). Methodology: It was a cross-sectional study. Thirty two newly diagnosed cases of pSLE were included in this study. Age and sex matched 10 apparently healthy children were selected as control. Results: Most common HLA-DR type among pSLE cases was DR15(63%) followed by DR07 (41%) and DR04 (31%). HLA-DR07 was positive in 80% of control group (p<0.05). In this study, pSLE patients presented with constitutional symptoms (93.8%) followed by skin rash (84%), renal features (75%), gastrointestinal (69%) and musculoskeletal (63%) manifestations. HLA-DR15, DR07 and DR04 were frequently positive in above mentioned manifestations, but HLA-DR13 was not present in patients with renal and haematological manifestations. HLA-DR11 and DR13 showed significant association with arthritis, and hematologic manifestation was associated with DR11.Conclusions: Among HLA-DR types, most frequently associated alleles were DR15 followed by DR07 and DR04.This study found significant association of HLA-DR typeswith different clinical manifestations in pSLE patients.

Keywords: Major histocompatibility complex, HLA-DR.