HLA-DR7 in association with chlorpromazine-induced lupus anticoagulant (LA)

J Autoimmun. 1997 Dec;10(6):579-83. doi: 10.1006/jaut.1997.0165.

Abstract

The presence of anti-phospholipid antibodies (aPL) has been associated with the major histocompatibility complex (MHC) genes. These autoantibodies occur in individuals with infections such as that produced by the human immunodeficiency virus 1 (HIV-1) or with syphilis, but they can also occur in drug-induced lupus-like syndromes. In the present study, we analysed the presence of aPL (detected as lupus anti-coagulant) and its relationship with the MHC markers in 93 Caucasian psychiatric patients chronically treated with chlorpromazine. Forty-one out of 93 patients were positive for LA, and the HLA-DR7 antigen was significantly increased in LA-positive patients as compared to normal controls or LA-negative patients (PC = 0.024, RR = 2.12 and P = 0.05, RR = 1.57, respectively). Likewise, we noted a significantly increased frequency of HLA-B44 in LA-positive patients as compared to normal controls (PC = 0.024, RR = 2.12), but not when compared to aPL-negative patients. No significant differences were found among any other class I, II or III MHC antigens. Haplotype analysis showed that DR7 was mostly part of the HLA-B44-DR7-FC31 and B7-DR7-SC31 haplotypes. These results suggest that the HLA-DR7 antigen might be playing a role in the production of aPL in chlorpromazine-treated patients.

MeSH terms

  • Adult
  • Affective Disorders, Psychotic / blood
  • Affective Disorders, Psychotic / drug therapy
  • Bipolar Disorder / blood
  • Bipolar Disorder / drug therapy
  • Child
  • Chlorpromazine / adverse effects*
  • Chlorpromazine / therapeutic use
  • Drug Administration Schedule
  • Female
  • Genes, MHC Class I / drug effects
  • Genes, MHC Class I / physiology
  • Genes, MHC Class II / drug effects
  • Genes, MHC Class II / physiology
  • HLA-DR7 Antigen / blood*
  • Humans
  • Lupus Coagulation Inhibitor / biosynthesis*
  • Male
  • Neurocognitive Disorders / blood
  • Neurocognitive Disorders / drug therapy
  • Psychotic Disorders / blood
  • Psychotic Disorders / drug therapy
  • Schizophrenia / blood
  • Schizophrenia / drug therapy

Substances

  • HLA-DR7 Antigen
  • Lupus Coagulation Inhibitor
  • Chlorpromazine