Must HLA-B27 be positive in patients with ankylosing spondylitis?
May 25, 2023
Source: Cainiu Health
Dr. Liu Aihua
Introduction
In most cases, the majority of patients with ankylosing spondylitis test positive for HLA-B27, although a small number of ankylosing spondylitis patients may be HLA-B27 negative. Patients with ankylosing spondylitis are more likely to be HLA-B27 positive; however, a diagnosis of ankylosing spondylitis cannot be made based solely on a positive HLA-B27 result.
Under normal circumstances, most patients with ankylosing spondylitis test positive for HLA-B27, although there are rare cases in which patients with ankylosing spondylitis test negative for HLA-B27. The detailed analysis is as follows:
If a patient has ankylosing spondylitis, the likelihood of testing positive for HLA-B27 is higher. However, it is incorrect to diagnose ankylosing spondylitis based solely on a positive HLA-B27 result. Diagnosis typically requires a comprehensive evaluation incorporating clinical symptoms, imaging studies, and serological tests. Therefore, a negative HLA-B27 test does not completely rule out ankylosing spondylitis. HLA-B27 positivity in ankylosing spondylitis is associated with an inherited disorder caused by immune system abnormalities. This condition can lead to segmental pathological changes characteristic of ankylosing spondylitis, with prominent symptoms including lower back pain, morning stiffness that worsens with rest, and in some patients, dull pain in the sacroiliac region, hip joint deformities, spinal deformities, and restricted mobility.
In summary, a negative HLA-B27 test cannot entirely exclude the possibility of ankylosing spondylitis. Patients experiencing the aforementioned symptoms should promptly seek medical attention at a qualified hospital and undergo standardized diagnosis and treatment under a physician's guidance to avoid misdiagnosis or missed diagnosis and to ensure timely intervention during the optimal treatment window.
