The British Journal of Rheumatology, Vol 36, 310-314, Copyright © 1997 by British Society for Rheumatology
T Schaeverbeke, H Renaudin, M Clerc, L Lequen, JP Vernhes, B De Barbeyrac, B Bannwarth, C Bebear and J Dehais
The objective was to investigate the presence of mycoplasmas in rheumatoid
arthritis (RA) and other chronic arthritides. Samples of synovial fluid
(SF) were systematically collected from all patients presenting with an
articular effusion. Each sample was divided into three parts. The first was
kept for cytological count and culture on standard media for pyogens and
mycobacteria, the second was cultivated on specific media for mycoplasmas
and the third frozen for subsequent study by polymerase chain reaction
(PCR). A total of 209 samples were studied. Half of the patients had
inflammatory rheumatic diseases: RA (27), spondyloarthropathy (28),
connective tissue disease (5), unclassified arthritis (45). The remaining
suffered from other conditions, including osteoarthritis (60), gouty
arthritis (19), haemarthrosis (5), post-traumatic effusion (2). Eight
samples were positive by culture, two for Mycoplasma hominis; three for M.
fermentans, one for M. salivarium, one for M. orale and one for Ureaplasma
urealyticum. All the patients concerned had an inflammatory rheumatic
disease: five had RA, one had psoriatic arthritis and two had unclassified
arthritis. These results were confirmed by PCR in two cases (one M.
fermentans, one U. urealyticum). The lack of sensitivity of the
conventional PCR assay on SF is discussed. Mycoplasmas were mainly detected
in SF of RA patients. These results raise the question of the possible role
of mycoplasmas in the triggering and maintenance of inflammatory rheumatic
diseases, especially RA.
ORIGINAL PAPERS
Systematic detection of mycoplasmas by culture and polymerase chain reaction (PCR) procedures in 209 synovial fluid samples
Service de Rhumatologie, Centre Hospitalier Pellegrin, Universite de Bordeaux II, France.
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