Palindromic onset of rheumatoid arthritis. Clinical, synovial fluid, and biopsy studies.
Palindromic onset of rheumatoid arthritis. Clinical, synovial fluid, and biopsy studies.
复制标题
类风湿性关节炎回文发作。
作者：
H. Schumacher
5例患者有发作性关节炎，与复发性风湿病一致，在1年或更长时间后演变为明确或典型的类风湿关节炎。复发期滑膜积液有不同的白细胞计数；4例患者以单核细胞为主。这些积液和针状滑膜活检显示亚急性浅表炎症和微血管疾病，都不能预测疾病会发展为类风湿关节炎。血管壁上的电子致密沉积物提示循环免疫复合物。在血管壁和吞噬空泡中也有明显的、未识别的碎片，这可能在发病机制中也很重要。
Five patients had episodic arthritis consistent with palindromic rheumatism that evolved into definite or classic rheumatoid arthritis after 1 or more years. Synovial effusions during palindromic episodes had various leukocyte counts; mononuclear cells predominated in 4 patients. Neither these effusions nor needle synovial biopsies that showed subacute superficial inflammation and microvascular disease allowed any prediction that the disease would evolve into rheumatoid arthritis. Electron-dense deposits in vessel walls suggested circulating immune complexes. There was also prominent, unidentified debris in vessel walls and in phagocytic vacuoles, which might also be important in pathogenesis.