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(Chest. 2000;117:482-485.)
© 2000 American College of Chest Physicians

Mediastinal Fibrosis Is Associated With Human Leukocyte Antigen-A2*

R. Stokes Peebles, MD; Chace T. Carpenter, MD; William D. Dupont, PhD and James E. Loyd, MD

* From the Center for Lung Research and Department of Medicine (Drs. Peebles, Carpenter, and Loyd) and the Department of Preventive Medicine (Dr. Dupont), Vanderbilt University School of Medicine, Nashville, TN. Supported by NIH Grants HL 07123, K08 HL 03730, HL 48164; and Dialysis Clinics Inc.

Correspondence to: James E. Loyd, MD, Professor of Medicine, T-1219 MCN Vanderbilt University, Nashville, TN 37232-2386; e-mail: Jim.Loyd{at}mcmail.vanderbilt.edu

Objective: To determine the association between mediastinal fibrosis and human leukocyte antigen (HLA) genes.

Design: Case-control study.

Setting: Vanderbilt University Medical Center.

Subjects: Nineteen consecutive patients with mediastinal fibrosis who presented to the pulmonary clinic at Vanderbilt University Medical Center from 1987 to 1996. The control subjects were 21,086 whites who were cadaveric kidney donors from October 1987 through December 1993.

Measurements: HLA testing was performed on blood samples from all 19 cases. Information on HLA typing for the control subjects was obtained from the United Network for Organ Sharing. Frequency of HLA class I and II antigens found in the cases was compared with the frequency in the control subjects.

Results: The relative risk of mediastinal fibrosis among subjects with the HLA-A2 antigen was 3.32 times that of those who lacked this antigen (95% confidence interval, 1.19 to 9.2).

Conclusion: HLA-A2 was strongly associated with mediastinal fibrosis, suggesting that an abnormal immune response is important in the pathogenesis of this disease. Key words: Histoplasma capsulatum; human leukocyte antigen-A2; mediastinal fibrosis




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