rss
Br J Ophthalmol 2000;84:1125-1129 doi:10.1136/bjo.84.10.1125
  • Original Article
    • Clinical science

Bartonella henselae associated uveitis and HLA-B27

  1. F T Kerkhoff,
  2. A Rothova
  1. Department of Ophthalmology, FC Donders Institute, University Hospital, 3508 GA Utrecht, Netherlands
  1. Dr F T Kerkhofffkerkho{at}oogh.azu.nl
  • Accepted 3 May 2000

Abstract

AIM To investigate the frequency of HLA-B27 in patients with presumedBartonella henselae associated uveitis and to describe the clinical characteristics of HLA-B27 positive patients with uveitis and presumed ocular bartonellosis (POB).

METHODS The diagnosis of POB was considered in 19 patients with unexplained uveitis (except for the HLA-B27 association) and high positive IgG (titre ≥1:900) and/or IgM (titre ≥1:250) antibodies against B henselae. In addition to B henselaeserology and HLA-B27 typing, all patients underwent an extensive standard diagnostic screening procedure for uveitis and in all cases the results were within the normal limits. The control group consisted of 25 consecutive patients with panuveitis and negativeB henselae serology.

RESULTS HLA-B27 was positive in six of the 19 patients (32%) with POB in contrast to the 4% frequency of HLA-B27 in the control group (p=0.03) and 8% prevalence of HLA-B27 in the Dutch population (p=0.003). At the time of positive Bartonella serological testing five of six HLA-B27 positive patients with POB had severe posterior segment involvement with papillitis, macular oedema, and vitreitis. The duration of intraocular inflammatory activity was more than 6 months in five HLA-B27 positive patients. Although four of the six HLA-B27 positive patients had previous recurrent attacks of acute anterior uveitis, the clinical presentation at the time of positiveBartonella serology differed, as illustrated by the involvement of the posterior segment and chronic course of the ocular disease.

CONCLUSIONS The frequency of HLA-B27 in patients with uveitis and serological characteristics of acute infection with B henselae is higher than in the general Dutch population. The findings of this study also suggest a relation between infection withBartonella species and HLA-B27.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.