HL-A antigens and the sicca syndrome.

The recent interest in the HL-A typing as applied to the rheumatic diseases (Brewerton, Caffrey, Hart, James, Nicholls, and Sturrock, 1973; Schlosstein, Terasaki, Bluestone, and Pearson, 1973) has prompted us to investigate the possible association of an HL-A antigen in patients with the 'sicca syndrome', viz. keratoconjunctivitis sicca and xerostomia. Birch, Bunim, and Bloch (1963) in a clinical and serological study of fourteen patients with Sjogren's syndrome and 121 blood relatives have demonstrated familial aggregation of possible or probable rheumatoid arthritis, decreased lacrimal secretion, and abnormal circulating antibodies. They presented evidence to suggest that this may be due to heredity rather than environmental factors. The peculiar association of the 'sicca syndrome' with malignant lymphoreticular neoplasms (Talal, Sokoloff, and Barth, 1967; Azzopardi and Evans, 1971) is also interesting in view of the association between lymphoma and HL-A5 and WI 8 (Zervas, Delamore, Israels, 1970). Material and methods To assess whether these observations could be explained by a particular HL-A antigen, we have studied 21 patients (age range 24 to 86 years; mean 61) with the sicca syndrome of whom nineteen had a depressed salivary flow rate and sixteen a positive labial gland biopsy (Whaley, Chisholm, Downie, Dick, and Williamson, 1968). Rheumatoid factor was present in the serum of sixteen patients) ten had a positive antinuclear factor (titre 1:1-61:256), and six complained of joint pains. HL-A typing was performed using a modification of the technique of KissmeyerNielsen and Kyerbye (1967).