Establishment of reference interval of human leukocyte antigen-B27 in apparent healthy children

doi:10.3969/j.issn.1673-8640.2020.07.015

Abstract

Abstract:

Objective To establish the reference interval of human leukocyte antigen-B27（HLA-B27） in apparent healthy children,and to provide a reference for the diagnosis and differential diagnosis of juvenile idiopathic arthritis（JIA）enthesitis related arthritis（ERA） in children. Methods A total of 460 children without conscious spine,peripheral joints,inflammation around the joints or other lesions were enrolled to establish the reference interval. Another 200 apparent healthy children and 50 ERA children were enrolled to verify the reference interval. Peripheral blood HLA-B27 was determined,and the reference interval was established and verified. Results The HLA-B27 mean fluorescence intensity of 460 children showed a skewed distribution（Z=1.615,P=0.011）,which was 100（78-121） expressed as median（M） [percentiles（P_2.5-P_97.5）]. There was no statistical significance for the mean fluorescence intensity of HLA-B27 with different ages and sex（P>0.05）. The percentile method was used to establish a 97.5% reference interval on one side,and the HLA-B27 reference interval was <121. Consistency comparison results showed that the new reference interval and the HLA-B27 reference interval provided by manufacturer（0-147） showed a poor consistency（kappa=0.013,P<0.001）. According to the new reference interval,the abnormal rate of HLA-B27 in 200 apparent healthy children was 5%,and the positive rate of HLA-B27 in 50 children with ERA was 78%. According to the reference interval provided by manufacturer,the abnormal rate of HLA-B27 in 200 apparent healthy children was 3%,and the positive rate of HLA-B27 in 50 children with ERA was 26%. There was no statistical significance for the abnormal rate of HLA-B27（χ²=1.41,P>0.05）,and the difference of positive rate fo HLA-B27 had statistical significance（χ²=49.18,P<0.001）. Conclusions The reference interval of HLA-B27 in peripheral blood of children in Nanjing has been established. The specificity of reference interval for the diagnosis of ERA is not different from the reference interval provided by manufacturer,but it improves the diagnostic sensitivity and decreases the rate of missed diagnosis.

Key words: Human leukocyte antigen-B27, Children, Reference interval, Flow cytometry

CLC Number:

R446.1

ZHANG Li, GE Liang, ZHANG Lanfang, MA Xiaoli, SUN Linchun. Establishment of reference interval of human leukocyte antigen-B27 in apparent healthy children[J]. Laboratory Medicine, 2020, 35(7): 695-698.

Figures/Tables 2

References 10

[1]	BREWERTON D A,JOSEPH J.Bunim memorial lecture. HLA-B27 and the inheritance of susceptibility to rheumatic disease[J]. Arthritis Rheum,1976,19(4):656-668.
[2]	SIALA M,MAHFOUDH N,GDOURA R,et al.Distribution of HLA-B27 and its alleles in patients with reactive arthritis and with ankylosing spondylitis in Tunisia[J]. Rheumatol Int,2009,29(10):1193-1196.
[3]	李玉慧,姚海红,贾园,等. 以关节炎为首发表现的银屑病关节炎患者的临床及实验室特征[J]. 中华医学杂志,2016,96(11):883-885.
[4]	张金飞. 强直性脊柱炎患者血液HLA-B27的临床参考值的预测[J]. 放射免疫学杂志,2012,25(3):319-322.
[5]	PETTY R E,SOUTHWOOD T R,MANNERS P,et al.International League of Associations for Rheumatology classification of juvenile idiopathic arthritis:second revision,Edmonton,2001[J]. J Rheumatol,2004,31(2):390-392.
[6]	SRIVASTAVA R,PHATAK S,YADAV A,et al.HLA B27 typing in 511 children with juvenile idiopathic arthritis from India[J]. Rheumatol Int,2016,36(10):1407-1411.
[7]	JUNG S H,CHO S M,YIM S H,et al.Developing a risk-scoring model for ankylosing spondylitis based on a combination of HLA-B27,single-nucleotide polymorphism,and copy number variant markers[J]. J Rheumatol,2016,43(12):2136-2141.
[8]	ASQUITH M,DAVIN S,STAUFFER P,et al.Intestinal metabolites are profoundly altered in the context of HLA-B27 expression and functionally modulate disease in a rat model of spondyloarthritis[J]. Arthritis Rheumatol,2017,69(10):1984-1995.
[9]	CARRASCO R.Juvenile idiopathic arthritis overview and involvement of the temporomandibular joint:prevalence,systemic therapy[J]. Oral Maxillofac Surg Clin North Am,2015,27(1):1-10.
[10]	卫生部临床检验标准专业委员会. WS/T402—2012 临床实验室检验项目参考区间的制定[S]. 北京:中国标准出版社,2013.

年龄	例数	HLA-B27平均荧光强度
<3岁	29	96 （78~107）
3~<6岁	95	99 （79~113）
6~<12岁	255	100 （76~119）
≥12岁	98	98 （72~115）
χ²值		3.438
P值		0.329

年龄	例数	HLA-B27平均荧光强度
<3岁	29	96 （78~107）
3~<6岁	95	99 （79~113）
6~<12岁	255	100 （76~119）
≥12岁	98	98 （72~115）
χ²值		3.438
P值		0.329

性别	例数	HLA-B27平均荧光强度
男性	255	97（74~116）
女性	205	101（81~110）
χ²值		3.766
P值		0.282

性别	例数	HLA-B27平均荧光强度
男性	255	97（74~116）
女性	205	101（81~110）
χ²值		3.766
P值		0.282

[1]	WANG Huiying, TANG Yu, DONG Lili, WANG Jing. Role of Mycoplasma pneumoniae RNA determination in diagnosis and efficacy monitoring of pneumonia in children [J]. Laboratory Medicine, 2023, 38(9): 865-869.
[2]	SHI Yingying, PAN Fen, SUN Yan, WANG Chun, JIANG Jie, YU Fangyuan, ZHANG Tiandong, QIN Huihong, ZHANG Hong. Nested multiple polymerase chain reaction in rapid diagnosis of meningitis/encephalitis in children [J]. Laboratory Medicine, 2023, 38(8): 766-770.
[3]	FU Limei, YANG Dan, XU Jin, ZHU Haiyan, ZHU Fenhua. Clinical significance of whole blood trace elements and serum vitamin levels in 6 common skin diseases in children [J]. Laboratory Medicine, 2023, 38(8): 771-775.
[4]	ZHANG Xin, MA Lijuan. Role of cardiac markers in children [J]. Laboratory Medicine, 2023, 38(6): 505-509.
[5]	YANG Qiong, XU Fen, LIN Yahui. Clinical application of cardiac troponin determination in pediatric cardiac involvement related diseases [J]. Laboratory Medicine, 2023, 38(6): 510-517.
[6]	LI Li, SUN Haiyan, LI Yuanrui, DOU Min, TANG Wen, JIANG Limin, SHEN Lisong. Changes and clinical roles of perioperative NT-proBNP and PCT in children with congenital heart disease [J]. Laboratory Medicine, 2023, 38(6): 524-531.
[7]	LIU Junshan, GUO Mingfa, SUN Jia, SHI Lihuan, LIU Wei, DUAN Yongtao. Significance of minimal residual disease dynamic monitoring in the prognosis of acute B-lymphoblastic leukemia children with positive and negative ETV6/RUNX1 fusion genes [J]. Laboratory Medicine, 2023, 38(3): 209-214.
[8]	WANG Yaling, HUANG Yunli, TIAN Mi, WANG Shunlan, XIAO Li. Relationship between EOS%，CCR3，eotaxin and disease severity in children with acute bronchopneumonia [J]. Laboratory Medicine, 2023, 38(3): 230-234.
[9]	WU Jinying, FANG Yulian, WANG Wei, HOU Mengzhu, WANG Lu, ZHAO Yu. Clinical characteristics and epidemiological of enterovirus infection in children with acute diarrhea in Tianjin [J]. Laboratory Medicine, 2023, 38(3): 267-271.
[10]	AN Yinghong, YAO Kechun, SU Chengming, TANG Jinhua, YANG Lixin, GAO Jie, XU Yanting, YAN Qiuhong, ZHAN Hongyan, MA Yueyun. Survey of serum homocysteine levels of apparently healthy subjects in Beijing [J]. Laboratory Medicine, 2023, 38(11): 1036-1040.
[11]	ZHAO Yanhong, FU Lin, LIU Biao, XIAO Meifang. Reference interval of lactate dehydrogenase among 3-14-year-old population in Hainan [J]. Laboratory Medicine, 2023, 38(11): 1041-1043.
[12]	HU Shaohua, CHEN Li, ZHAO Meng, MA Zhan, ZHANG Hong. Epidemiological characteristic analysis of Mycoplasma pneumoniae infection in children in Shanghai [J]. Laboratory Medicine, 2023, 38(1): 14-17.
[13]	WEI Rui, YUAN Xu, TIAN Xuewen, LU Yanjun. Clinical and laboratory characteristics of human metapneumovirus infection children in a Grade A Class 3 hospital in Wuhan [J]. Laboratory Medicine, 2023, 38(1): 18-22.
[14]	ZHANG Yaxu, CUI Yanwei, LIU Ziyan. Preliminary research for the determination of HPV E6/E7 mRNA by nucleic acid molecular hybridization-flow cytometry [J]. Laboratory Medicine, 2023, 38(1): 46-50.
[15]	LU Lijuan, XU Jin. Thoughts on whether adenovirus is the cause of the hepatitis of unknown etiology among children recently [J]. Laboratory Medicine, 2022, 37(8): 705-709.