Immunogenetic prediction of pulmonary fibrosis in systemic sclerosis

75 systemic sclerosis patients were independently tested for pulmonary fibrosis, autoantibodies, and MHC class II genes. 24 of 42 (57%) patients with pulmonary fibrosis had either HLA DR3/DRw52a or anti-Scl-70 vs 2 of 33 (6%) patients without pulmonary fibrosis. The presence of DR3/DRw52a or anti-Scl-70 gives a relative risk of 16·7 for the development of pulmonary fibrosis in a patient with scleroderma—a risk substantial enough to require careful monitoring of these patients and treatment at an early stage of disease.