Abstract
The histological features of the synovial membrane in rheumatoid arthritis (RA) are shared by other chronic inflammatory joint diseases, so that diagnostic differentiation is impossible. Examination of the immunoglobulin class in the plasma cells present in inflamed synovial membranes, however, has shown differences. Synovial membranes from 12 patients were seropositive RA, eight with seronegative RA, eight with ankylosing spondylitis, five with psoriatic arthritis, and three with Reiter's syndrome have been compared by peroxidase-antiperoxidase (PAP) staining for immunoglobulin classes on routinely paraffin wax embedded sections. There were no significant differences in the percentages of plasma cells containing IgG of IgA between the diseases studied. There were, however, significantly more plasma cells containing IgM in patients with seropositive RA (2-34%) compared with those with seronegative RA (0-10%; p less than 0.002) and with other chronic synovitides (0-9%; p less than 0.002). The results show that it is possible to distinguish seropositive RA from other chronic inflammatory joint diseases by PAP staining for immunoglobulin classes in the plasma cells present in the inflamed synovial membrane.
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Selected References
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- Bonomo L., Tursi A., Gillardi U. Distribution of the anti-gamma globulin factors in the synovial membrane and other tissues in various diseases. Ann Rheum Dis. 1968 Mar;27(2):122–129. doi: 10.1136/ard.27.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper N. S., Soren A., McEwen C., Rosenberger J. L. Diagnostic specificity of synovial lesions. Hum Pathol. 1981 Apr;12(4):314–328. doi: 10.1016/s0046-8177(81)80141-4. [DOI] [PubMed] [Google Scholar]
- Friis J. Immunohistochemical demonstration of rheumatoid factor (RF) in alcohol-fixed synovial tissue from patients with rheumatoid arthritis (RA). Acta Pathol Microbiol Scand. 1969;75(1):71–84. [PubMed] [Google Scholar]
- Fyrand O., Mellbye O. J., Natvig J. B. Immunofluorescence studies for immunoglobulins and complement C3 in synovial joint membranes in psoriatic arthritis. Clin Exp Immunol. 1977 Sep;29(3):422–427. [PMC free article] [PubMed] [Google Scholar]
- Goldenberg D. L., Cohen A. S. Synovial membrane histopathology in the differential diagnosis of rheumatoid arthritis, gout, pseudogout, systemic lupus erythematosus, infectious arthritis and degenerative joint disease. Medicine (Baltimore) 1978 May;57(3):239–252. doi: 10.1097/00005792-197805000-00004. [DOI] [PubMed] [Google Scholar]
- McCormick J. N. An Immunofluorescence Study of Rheumatoid Factor. Ann Rheum Dis. 1963 Jan;22(1):1–10. doi: 10.1136/ard.22.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mestecky J., Miller E. J. Presence of antibodies specific to cartilage-type collagen in rheumatoid synovial tissue. Clin Exp Immunol. 1975 Dec;22(3):453–456. [PMC free article] [PubMed] [Google Scholar]
- Munthe E., Natvig J. B. Immunglobulin classes, subclasses and complexes of IgG rheumatoid factor in rheumatoid plasma cells. Clin Exp Immunol. 1972 Sep;12(1):55–70. [PMC free article] [PubMed] [Google Scholar]
- Revell P. A., Mayston V. Histopathology of the synovial membrane of peripheral joints in ankylosing spondylitis. Ann Rheum Dis. 1982 Dec;41(6):579–586. doi: 10.1136/ard.41.6.579. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosenberger J. L., Cooper N. S., Soren A., McEwen C. A statistical approach to the histopathologic diagnosis of synovitis. Hum Pathol. 1981 Apr;12(4):329–337. doi: 10.1016/s0046-8177(81)80142-6. [DOI] [PubMed] [Google Scholar]