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We have HLA typed 50 Arab patients with cutaneous lichen planus who were resident in Kuwait and then compared the antigen incidence with 100 normal controls. There were no significant differences in the antigens of the HLA-ABC loci but there was a significant increase in HLA-DR1 (P = 0.0018, RR = 3.68) and HLA-DR10 (P. corr. = 0.00096, RR = 8.27) and a significant decrease in HLA DR5 (P. corr. = 0.0396, RR = 0.18). The relevance of these findings to earlier reports on lichen planus in which HLA-DR1 (but not DR10) is increased is discussed. This is the first report of HLA antigen frequency in Arab patients with lichen planus, and would support the fact that HLA DR1 is universally associated with the disease, although the more significant association appears to be with HLA-DR10.

Forty-eight Arab patients with steroid-responsive childhood nephrotic syndrome were studied for the frequency of HLA-A, -B, -C and -DR antigens. HLA-DR7 was significantly increased in the patient group (63% vs. 28%, P = 0.0002) confirming reports of a DR7 association in other ethnic groups and indicating a universal association with this antigen. HLA-CW6 was also significantly increased (44% vs. 21%, P corr. = 0.042). HLA-DQW1 was significantly reduced in the patients (29% vs. 57%, P corr. = 0.012) as was HLA-CW4 (6% vs. 24%, P corr. = 0.042).

Eighty-five Arab patients in Kuwait with classical and definite rheumatoid arthritis were typed to examine the frequency of HLA-A, B, C, and DR antigens. The results showed a significant increase in the frequency of HLA-A10, B8, B21, and DR3 antigens when compared to an age- and sex-matched control population. HLA-DR3 was present in 34 per cent of the patients compared with 2 per cent of the controls (p less than 0.001). The association of RA in the Arab population with HLA-DR3 rather than HLA-DR4 or HLA-DR1 as reported in other ethnic groups emphasizes further the complexity of the genetics of RA.

Four cases of Takayasu's disease in female Arabs are reported. All patients had classical features of the disease. Typing for HLA phenotype showed that all patients had HLA A2, A9, BW35 and DR7 antigens, suggesting an immunogenetic basis for the disease. As far as we know, this is the first report of Takayasu's disease in this ethnic group.

Sixty-five Arab children in Kuwait with recurrent infections were subjected to laboratory investigations to determine their immune function. Twenty (31%) of these children were found to have a primary immunodeficiency syndrome, 36 patients (55%) had laboratory abnormalities but could not be classified, three patients (5%) had other well defined diseases responsible for their laboratory defect, and six patients (9%) had normal laboratory values. The most common infection site was the upper respiratory tract or chest, and the most frequent organisms isolated were Candida albicans, Staphylococcus aureus and Salmonella sp. in patients in whom detailed information was available, 70% had a family history of similar disease and 68% had consanguinous parents. These children represent only a fraction of those that should be investigated and it is recommended that a referral center for the investigation of children with recurrent infection be established.