原田病の臨床症状とHLA抗原との関連

Correlation between HLA antigens and clinical manifestations in Harada disease

　原田病患者について，臨床症状の重篤度とHLA抗原との相関を検索した。96症例の検査結果ではBw54, Cw1, DR4, DRw53, DQw3が有意に頻度が高かった。DQw3が最も高く，DR4よりもBW54が低かった。この結果，原田病の疾患感受性遺伝子はDQ Locusの付近にあると推定された。

　ステロイド大量療法が行われなかった45症例では，Bw54, DR4, Cw1のいずれもがない群で，臨床症状が軽症であり，予後が良好であった。特定の抗原の組み合わせが臨床症状の重症度と関係する所見は観察されなかった。

We evaluated 96 patients of Harada disease regarding the clinical manifestations and HLA antigens. There was a high incidence in the follow-ing antigens : Bw54 (44%) , Cw1 (57%), DR4 (87%), DRw53 (95%) and DQw3 (97%), with χ² of 24.12, 11.67, 45.30, 56.90 and 87.87 and relative risk of 3.35, 2.39, 7.52, 17.91 and 34.95 respectively. There was a significantly low incidence of Aw33 (5%) and B44 (4%), with χ² of 5.42 and 8.52 and relativerisk of 0.35 and 0.24 respectively. The higher inci-dence of DQw3 than Bw54 and DR4 seemed to suggest that the gene responsible for Harada dis-ease is located near the DQ locus.

We then evaluated 45 patients in the series who were not treated with megadosis of systemic cor-ticosteroid. Patients who possessed none of Bw54, and Cwl tended to show mild clinical course and favorable outcome. There was no significant corre-lation between the clinical course and presence of more than two of these antigens.