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HLA B27 in Rheumatoid Factor-Negative Polyarthritis

J. M. ESDAILE, M.D., F.R.C.P.(C); I. L. DWOSH, M.D., F.R.C.P.(C); M. B. UROWITZ, M.D., F.R.C.P.(C), F.A.C.P.; H. A. SMYTHE, M.D., F.R.C.P.(C); and J. FALK
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▸Requests for reprints should be addressed to M. B. Urowitz, M.D.; 659 Rheumatic Disease Unit, The Wellesley Hospital; 160 Wellesley Street East; Toronto, ON M4Y 1J3, Canada.

Toronto, Ontario, Canada

Ann Intern Med. 1977;86(6):699-702. doi:10.7326/0003-4819-86-6-699
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Eighty-three consecutive patients with rheumatoid factor-negative polyarthritis seen during a 1-year period were evaluated clinically, radiologically, and with the B27 test. Patients with definite spondylitis, juvenile chronic polyarthritis, a collagen disease, a known metabolic arthropathy, or primary generalized osteoarthritis were excluded. The patients could be classified into two groups independent of any knowledge of B27 testing. Twenty-five had a spondylitic "variant" syndrome. These could be diagnosed on clinical grounds, and included a male preponderance and a high frequency of B27 positivity. Fifty-eight patients, who could generally be classified by American Rheumatism Association criteria as having definite or classic rheumatoid arthritis, included a female preponderance and a normal prevalence of B27. Thus the B27 test was not more helpful than clinical diagnosis in the classic spondylitic variant syndromes, nor did it separate out a population of patients from among the seronegative rheumatoid arthritis group.





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