Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1987 Mar;46(3):213–218. doi: 10.1136/ard.46.3.213

Immunopathological abnormalities in the normal skin of patients with rheumatoid arthritis in relation to clinical and serological findings: a one year follow up study.

M L Westedt, B J Vermeer, C J Meijer, M R Daha, W M Baldwin 3rd, A Cats
PMCID: PMC1002102  PMID: 3579385

Abstract

Fifty two patients with seropositive rheumatoid arthritis (RA) were studied over a period of one year to investigate possible relationships among changes of circulating immune complexes (CIC), deposits of immunoglobulins and complement around the cutaneous blood vessels, clinical activity of the disease, and the presence of extra-articular manifestations (EAM). The presence or absence of IgM and C3 in and around the cutaneous blood vessels correlated significantly with the presence or absence of extra-articular features in cross sectional and longitudinal studies. Patients with evidence of these cutaneous immune deposits also had a greater prevalence of CIC as determined by the Clq binding assay (ClqBA) or polyethylene glycol (PEG) assay for IC containing IgM (IgM IC). Although the degree of perivascular mononuclear cell infiltration around the blood vessels in the papillary dermis was related to the patients' clinical state at the initial assessment, it did not correlate with the later changes in the activity of the joint disease or the occurrence of EAM. Thus the deposition of immunoglobulin or complement, or both, seems to be independent of cellular infiltration. The meaning of these cellular infiltrates is not yet fully understood. Our study has shown that many patients with RA who appeared to have only joint disease in fact had subclinical systemic disease as reflected by a positive skin biopsy or CIC. Moreover, the disappearance of IgM deposits from the skin correlated with the disappearance of EAM and improvement of joint disease.

Full text

PDF
214

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Conn D. L., Schroeter A. L., McDuffie F. C. Cutaneous vessel immune deposits in rheumatoid arthritis. Arthritis Rheum. 1976 Jan-Feb;19(1):15–20. doi: 10.1002/art.1780190102. [DOI] [PubMed] [Google Scholar]
  2. González T., Garcia-Montelongo R., Gantes M. Cutaneous microvasculopathy in rheumatoid arthritis. J Rheumatol. 1985 Dec;12(6):1206–1207. [PubMed] [Google Scholar]
  3. Herrmann W. A., Kauffmann R. H., van Es L. A., Daha M. R., Meijer C. J. Allergic vasculitis. A histological and immunofluorescent study of lesional and non-lesional skin in relation to circulating immune complexes. Arch Dermatol Res. 1980;269(2):179–187. doi: 10.1007/BF00406538. [DOI] [PubMed] [Google Scholar]
  4. Jorizzo J. L., Daniels J. C., Apisarnthanarax P., Gonzalez E. B., Cavallo T. Histamine-triggered localized vasculitis in patients with seropositive rheumatoid arthritis. J Am Acad Dermatol. 1983 Dec;9(6):845–851. doi: 10.1016/s0190-9622(83)70196-9. [DOI] [PubMed] [Google Scholar]
  5. Kauffmann R. H., Van Es L. A., Daha M. R. Aggregated human immunoglobulin G stabilized by albumin: a standard for immune complex detection. J Immunol Methods. 1979;31(1-2):11–22. doi: 10.1016/0022-1759(79)90281-3. [DOI] [PubMed] [Google Scholar]
  6. Nelson H. M., MacKie R. M. Studies in cutaneous immunofluorescence. II. Histological and direct immunofluorescence observations in clinically normal skin of patients with rheumatoid arthritis. J Cutan Pathol. 1981 Apr;8(2):105–110. doi: 10.1111/j.1600-0560.1981.tb00993.x. [DOI] [PubMed] [Google Scholar]
  7. Nydegger U. E., Zubler R. H., Gabay R., Joliat G., Karagevrekis C. H., Lambert P. H., Miescher P. A. Circulating complement breakdown products in patients with rheumatoid arthritis. Correlation between plasma C3d, circulating immune complexes, and clinical activity. J Clin Invest. 1977 May;59(5):862–868. doi: 10.1172/JCI108708. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ollier W., Venables P. J., Mumford P. A., Maini R. N., Awad J., Jaraquemada D., D'Amaro J., Festenstein H. HLA antigen associations with extra-articular rheumatoid arthritis. Tissue Antigens. 1984 Nov;24(5):279–291. doi: 10.1111/j.1399-0039.1984.tb02139.x. [DOI] [PubMed] [Google Scholar]
  9. ROPES M. W., BENNETT G. A., COBB S., JACOX R., JESSAR R. A. 1958 Revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis. 1958 Dec;9(4):175–176. [PubMed] [Google Scholar]
  10. Rapoport R. J., Kozin F., Mackel S. E., Jordon R. E. Cutaneous vascular immunofluorescence in rheumatoid arthritis. Correlation with circulating immune complexes and vasculitis. Am J Med. 1980 Mar;68(3):325–331. doi: 10.1016/0002-9343(80)90100-x. [DOI] [PubMed] [Google Scholar]
  11. Ritchie D. M., Boyle J. A., McInnes J. M., Jasani M. K., Dalakos T. G., Grieveson P., Buchanan W. W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed] [Google Scholar]
  12. Westedt M. L., Breedveld F. C., Schreuder G. M., D'Amaro J., Cats A., de Vries R. R. Immunogenetic heterogeneity of rheumatoid arthritis. Ann Rheum Dis. 1986 Jul;45(7):534–538. doi: 10.1136/ard.45.7.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Westedt M. L., Daha M. R., de Vries E., Valentijn R. M., Cats A. IgA containing immune complexes in rheumatoid vasculitis and in active rheumatoid disease. J Rheumatol. 1985 Jun;12(3):449–455. [PubMed] [Google Scholar]
  14. Westedt M. L., Meijer C. J., Vermeer B. J., Cats A., de Vries E. Rheumatoid arthritis--the clinical significance of histo- and immunopathological abnormalities in normal skin. J Rheumatol. 1984 Aug;11(4):448–453. [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES