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Autoimmune

HLA-B27: an inherited immune protein linked to ankylosing spondylitis, psoriasis, bowel and eye inflammation

HLA-B27 is an inherited protein on the white blood cells and belongs to the HLA proteins, which the immune system uses to recognise which proteins belong to the body itself and which come from a virus or bacterium.

With HLA-B27 the chance of an autoimmune disease is higher, above all of ankylosing spondylitis (Bechterew's disease), an inflammatory disease of the joints, and of uveitis, an eye inflammation. According to the NVKC, HLA-B27 can also point to psoriasis, an inflammation of the skin, or to ulcerative colitis, an inflammation of the bowel. Only a blood test shows whether HLA-B27 is present.

The HLA-B27 result is positive or negative and has no unit; Star-SHL and Unilabs give negative as the reference value, and Certe and Diagnostiek voor U name no reference value. With symptoms of the joints, skin, bowel or eyes, a doctor weighs the result next to those symptoms.

Doctor's Assessment Included

HLA-B27 is an inherited protein on the white blood cells; the result is positive or negative. Star-SHL and Unilabs give negative as the reference value, Certe and Diagnostiek voor U give none.

  • With HLA-B27 the chance of ankylosing spondylitis and of uveitis is higher, but according to a 2022 review only 2 to 5 percent of people with HLA-B27 develop ankylosing spondylitis.
  • A negative HLA-B27 result does not rule out ankylosing spondylitis or a related disease.
  • A diagnosis such as ankylosing spondylitis cannot be made on an HLA-B27 test alone.

HLA B-27 (PCR): what this test measures

Whether HLA-B27 is present on the white blood cells is established by the HLA-B27 test, with a result of positive or negative. Certe uses a qualitative PCR for it, a technique that multiplies a small piece of DNA until it can be detected, and Star-SHL and Unilabs also name PCR as their method.

HLA B-27 (PCR): why this value matters

HLA-B27 matters because it raises the chance of several inflammatory diseases, but according to the NVKC the test is not specific: HLA-B27 also occurs in people without an autoimmune disease. According to the NVKC, a diagnosis therefore cannot be made on the HLA-B27 test alone.

Of the people who carry HLA-B27, only 2 to 5% develop ankylosing spondylitis, according to a 2022 review, which suggests that other genetic factors also play a part.

HLA B-27 (PCR): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

HLA B-27 (PCR): when is testing worthwhile?

For a long-lasting or sudden inflammation of the eyes or joints, a doctor can request an HLA-B27 test according to the NVKC, just as for pain and stiffness in the back and neck. HLA-B27 can then help with the diagnosis of above all ankylosing spondylitis, psoriasis, ulcerative colitis or uveitis.

According to the British guideline NICE NG65 for people over 16, axial spondyloarthritis, which covers ankylosing spondylitis, can be present while an ordinary X-ray shows no inflammation of the sacroiliac joint.

HLA B-27 (PCR): symptoms of a high or low value

Low Levels

With a negative HLA-B27 result, HLA-B27 is missing from the white blood cells, and the chance of ankylosing spondylitis, psoriasis, uveitis or Crohn's disease is then not raised, according to the NVKC. An autoimmune disease is not completely ruled out by it.

For people over 16, a negative HLA-B27 result is not by itself grounds to set spondyloarthritis aside, according to NICE NG65.

High Levels

With a positive HLA-B27 result, HLA-B27 is present on the white blood cells, with, according to the NVKC, a higher chance of an autoimmune disease, above all of ankylosing spondylitis or uveitis. HLA-B27 can also point to psoriasis or ulcerative colitis, and MedlinePlus states that HLA-B27 also occurs in healthy people.

According to MedlinePlus, HLA-B27 is also linked to psoriatic arthritis and to arthritis related to Crohn's disease or ulcerative colitis, a joint inflammation that goes together with a skin or bowel disease.

HLA B-27 (PCR): lifestyle and this value

A positive HLA-B27 result is a reason to discuss symptoms of the joints, back, eyes, skin or bowel with a doctor, because according to the NVKC a diagnosis is not made on the test alone. The doctor also checks whether autoimmune diseases run in the family, such as ankylosing spondylitis, psoriasis or an inflammation of the bowel.

HLA B-27 (PCR): frequently asked questions

Does ankylosing spondylitis also occur in women?

Yes, axial spondyloarthritis, which covers ankylosing spondylitis, affects about as many women as men in people over 16 according to the British guideline NICE NG65, and according to the same guideline the disease can also occur in people without HLA-B27.

Do children inherit HLA-B27?

Yes, children can inherit HLA-B27, because HLA-B27 is inherited, and according to ReumaNederland children of someone with axial spondyloarthritis can have a higher chance of developing the disease. Studies cited by MedlinePlus show that about three in four children who received HLA-B27 from a mother or father with ankylosing spondylitis do not get ankylosing spondylitis themselves.

Which diseases are linked to HLA-B27?

HLA-B27 is linked to spondyloarthritis, a form of joint inflammation that according to MedlinePlus includes ankylosing spondylitis, psoriatic arthritis, arthritis related to Crohn's disease or ulcerative colitis, reactive arthritis, inflammation of the sacroiliac joint and uveitis.

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HLA B-27 (PCR)

€149,-