Pathology · Immunopathology (Hypersensitivity, Autoimmunity, Immunodeficiency, Amyloidosis)

A 35-year-old man with a family history of autoimmune disease tests positive for HLA-DR4. Compared to the general population, he has increased risk of developing which autoimmune condition?

  • A Ankylosing spondylitis
  • B Celiac disease
  • C Rheumatoid arthritis
  • D Systemic lupus erythematosus
Correct answer: C. Rheumatoid arthritis

Explanation

HLA-DR4 is strongly associated with rheumatoid arthritis (shared epitope hypothesis). Ankylosing spondylitis is associated with HLA-C27. Celiac disease is linked to HLA-DQ2 and HLA-DQ8. SLE has weaker HLA associations (HLA-DR2, HLA-DR3). The shared epitope in HLA-DR4 molecules is thought to predispose to aberrant presentation of autoantigens.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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