How is human leukocyte antigen (HLA) B27 associated acute anterior uveitis (AAU) diagnosed?

Updated: Oct 30, 2018
  • Author: Anna Luisa Di Lorenzo, MBBCh; Chief Editor: Andrew A Dahl, MD, FACS  more...
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A careful history and physical examination usually helps distinguish between the uveitic entities associated with systemic disease and HLA-B27 from those that are not associated with HLA-B27. Disease entities causing AAU are varied and include traumatic iritis, postcataract extraction iritis, juvenile rheumatoid arthritis, herpetic infection (both herpes simplex and herpes zoster), syphilis, sarcoidosis, Fuchs heterochromic iridocyclitis, glaucomatocyclitic crisis, Behcet disease, and low-grade endophthalmitis. [12]

The role of HLA-B27 testing in patients with unilateral AAU is important in the differential diagnosis. The lack of HLA-B27 antigen in unilateral AAU may be a clue for the clinician to search for other specific uveitis entities and other systemic diseases. It also may be useful in determining the prognosis of AAU, as AAU associated with HLA-B27, even in the absence of systemic disease, is less favorable and more likely to recur when compared with that of patients who are HLA-B27 negative.

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