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(HLA) Hula-Bee (27) Bomber

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HLA-B27, human leukocyte antigen B27, is a class I surface antigen associated with seronegative arthropathies (no rheumatoid factor in serum). The diseases psoriatic arthritis, ankylosing spondylitis, inflammatory bowel disease and reactive arthritis are all associated with positive HLA-B27 status.

5 KEY FACTS

The acronym P-A-I-R can be used to represent the associated arthropathies of psoriatic arthritis, ankylosing spondylitis, irritable bowel disease and reactive arthritis.

Psoriatic arthritis is defined as joint pain and stiffness with psoriatic involvement. The psoriasis typically shows up in a patchy asymmetric pattern. Other associations include a pencil-in-cup deformity of joints seen on x-ray and sausage fingers.

Ankylosing spondylitis is characterized as chronic inflammation of the spine and sacroiliac joints. Patients complain of a stiff spine and ultimately, fusion occurs and a "bamboo spine" is seen on x-ray. Uveitis and aortic regurgitation are pathologies associated with this disease.

Crohn's disease and ankylosing spondylitis often involve peripheral arthritis and are associated with HLA-B27.

Reactive arthritis is another HLA-B27 positive arthropathy, which is characterized by the triad of conjunctivitis, urethritis and arthritis. This can be remembered by the phrase "Can't see, can't pee, can't bend my knee."

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