Objective: To determine the association between
mediastinal fibrosis and human leukocyte antigen (HLA) genes.
Design: Case-control study.
Vanderbilt University Medical Center.
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.
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).
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