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What is a serum HLA -B27 test for?

Q: My doctor has recommended a blood test for serum HLA -B27 Estimation and Serum RA test - Title. Are these tests necessary for joints pain? What type of disease is this? Is it curable or not? Is it very serious?

A:Please realise that blood tests are done and INTERPRETED ONLY in the context of the symptoms and signs of the patient. For example, HLA B27 is a gene that is present in 8-12% of normal Indians. Yet, in the presence of low-back pain and early morning stiffness in lower back that improves with exercise and does NOT improve with rest, presence of HLA B27 genes would indicate possible ankylosing spondylitis, an inflammatory autoimmune disease usually seen in young men below the age of 40 years, mostly below 25 years of age. Similarly, rheumatoid factor (or RF) is positive in 5% of normal persons and in a large number of other chronic diseases including malaria, hepatitis, tuberculosis etc. But, in a young-middle aged person (females:male ratio 4:1) with swelling and pain in the small joints of the fingers and the wrist joints, distributed in a symmetrical fashion, persisting for 6 weeks or more, associated with early morning stiffness, the presence of RF at a level that is more than 50 international units would indicate the presence of a serious systemic autoimmune disease called rheumatoid arthritis. Therefore, I suggest that you discuss the problem with your RHEUMATOLOGIST (not an Orthopaedic Surgeon, as Orthopaedic surgeons are NOT trained in the investigations, diagnosis and proper treatment of inflammatory autoimmune joint diseases).


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