HLA-B51 may serve as an immunogenetic marker for a subgroup of patients with Behcet's syndrome

Epidemiologic data, family history, clinical data, HLA typing, neutrophilic chemotaxis, and immunofluorescence of clinically normal non-sun-exposed skin were studied in 46 Israeli non-Ashkenazi Jewish and Arab patients with Behcet's syndrome. HLA-B51 was present in 71 percent of the patient group as compared with 13 percent of the control group (relative risk = 17.1). In four of 30 families in the B51-positive group, there was a close relative of the proband with Behcet's syndrome who was carrying the HLA-B51 antigen. Neutrophilic chemotaxis in this group was enhanced in 80 percent of the patients, and in most patients no deposition of immunoglobulin in the demo-epidermal junction was observed, whereas C₃ was present in papillary vessels. In the B51-negative group, the family history was negative for Behcet's syndrome, neutrophilic chemotaxis was enhanced in only two of eight patients, and in four of six patients, IgM deposition was detected in the dermo-epidermal junction. It is concluded that in Israeli non-Ashkenazi Jews and Arabs, there is a significant association between HLA-B51 and the risk of developing Behcet's syndrome. The B51-positive patient group has a family history of the disease, enhanced neutrophillic chemotaxis, and a lack of immunoglobulin deposition in the dermo-epidermal junction.