HLA-B27 and the spondylarthropathies in Lebanon: comment on the article by Awada et al
To the Editor:
1 work at an overseas American institution, and there are extended delays in receipt of journals by our medical library. So, it was only a few days ago that I saw the article entitled "Weak Association between HLA-B27 and the Spondylarthropies in Lebanon," which was published in the February 1997 issue of Arthritis & Rheumatism (1).
I would like to draw the attention of the Lebanese authors of that article to 2 points. First, the tabulated results in their Table 1 are misleading with respect to their reference 6, an article published by us (2). We published 2 tables in that article. Awada et a1 failed to mention that the frequencies of A9, A10, B12, B1.5, B16, B17, B21, B22, B40, and B47 were reported in our Table 1. Moreover, they erroneously report that the data for A23 and A24 (splits of A9), A25 and A26 (splits of AlO), BS1 and B.52 (splits of BS), B44 and B45 (splits of B12), and B49 and B50 (splits of B21) were not available in our article. Our Table 2 clearly showed the ratios for each of these splits.
Second, Awada et a1 failed to acknowledge the fact that it was first suggested and reported in 198.5 that B27 may not be associated with ankylosing spondylitis in Lebanese patients (3).
Two important statements we made in that article, one in the abstract and the other in the discussion section, were as follows. "The frequency of B27 in the Lebanese group studied was 1%. This may suggest that the established strong association between B27 and ankylosing spondylitis in Caucasians may not be applicable to Lebanese." "It is also noteworthy that the B27 frequency in this group was similar to that in blacks. If this frequency remains stable, then the strong association between B27 and ankylosing spondylitis in Caucasians may not be applicable to Lebanese, since it has already been mentioned that such a strong association does not exist in blacks.