Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (54)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Kraan, M. C.
Right arrow Articles by Tak, P. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kraan, M. C.
Right arrow Articles by Tak, P. P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Rheumatology 1999; 38: 1074-1080
© 1999 British Society for Rheumatology

Immunohistological analysis of synovial tissue for differential diagnosis in early arthritis

M. C. Kraan, J. J. Haringman1, W. J. Post2, J. Versendaal1, F. C. Breedveld1 and P. P. Tak

Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, Academic Medical Centre, Amsterdam,
1 Department of Rheumatology, Leiden University Medical Centre and
2 Department of Medical Statistics, Leiden University, Leiden, The Netherlands

Correspondence to: M. C. Kraan, Division of Clinical Immunology and Rheumatology FU, Dept of Internal Medicine, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands.

Objective. An early diagnosis in patients presenting with arthritis is important to provide information about prognosis and to initiate treatment. The objective of this study was to determine which markers applied in immunohistological analysis of synovial tissue (ST) specimens could be used to differentiate rheumatoid arthritis (RA) from other forms of arthritis.

Methods. Synovial biopsies were obtained by blind needle techniques from 95 patients with early arthritis. After follow-up of at least 2 yr to verify the diagnosis, the patients could be classified as follows: RA (n=36), undifferentiated arthritis (UA; n=21), osteoarthritis (OA; n=17), reactive arthritis (ReA; n=10), ankylosing spondylitis (AS; n=3), psoriatic arthritis (PsA; n=2) and crystal-induced arthritis (CA; n=6). ST sections were analysed by immunohistochemistry using monoclonal antibodies against CD3, CD4, CD8, CD22 (B cells), CD38 (plasma cells), CD68 (macrophages) and CD55 (fibroblast-like synoviocytes).

Results. Logistic regression analysis revealed that the higher scores for the numbers of CD38+ plasma cells and CD22+ B cells in RA were the best discriminating markers comparing RA to non-RA patients (CD38: P=0.0001; CD22: P<0.05). Polychotomous regression analysis comparing three diagnostic categories (1: RA; 2: UA, ReA, AS and PsA; 3: OA and CA) also identified the score for the number of CD38+ plasma cells (P<0.0001) as well as the numbers of CD68+ macrophages in the synovial sublining (P=0.05) as discriminating markers.

Conclusion. The results suggest that immunohistochemical analysis of ST specimens from early arthritis patients can be used to differentiate RA from non-RA patients. The numbers of plasma cells, B cells and macrophages are especially increased in ST of patients with RA. Future studies in early arthritis patients with clinical features which do not allow an immediate confident diagnosis may clarify the role of this test system in differential diagnosis.

KEY WORDS: Rheumatoid arthritis, Arthritis, Synovial tissue, Plasma cells, Macrophages, Differential diagnosis


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
G. Salvador, R. Sanmarti, B. Gil-Torregrosa, A. Garcia-Peiro, J. R. Rodriguez-Cros, and J. D. Canete
Synovial vascular patterns and angiogenic factors expression in synovial tissue and serum of patients with rheumatoid arthritis
Rheumatology, August 1, 2006; 45(8): 966 - 971.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
E. J. A. Kroot, A. E. A. M. Weel, J. M. W. Hazes, P. E. Zondervan, M. P. Heijboer, P. L. A. van Daele, and R. J. E. M. Dolhain
Diagnostic value of blind synovial biopsy in clinical practice
Rheumatology, February 1, 2006; 45(2): 192 - 195.
[Abstract] [Full Text] [PDF]

Home page
 J. Immunol.Home page
E. Jimenez-Boj, K. Redlich, B. Turk, B. Hanslik-Schnabel, A. Wanivenhaus, A. Chott, J. S. Smolen, and G. Schett
Interaction between Synovial Inflammatory Tissue and Bone Marrow in Rheumatoid Arthritis
J. Immunol., August 15, 2005; 175(4): 2579 - 2588.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
M D Smith, E Barg, H Weedon, V Papengelis, T Smeets, P P Tak, M Kraan, M Coleman, and M J Ahern
Microarchitecture and protective mechanisms in synovial tissue from clinically and arthroscopically normal knee joints
Ann Rheum Dis, April 1, 2003; 62(4): 303 - 307.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
M. D. Smith, M. C. Kraan, J. Slavotinek, V. Au, H. Weedon, A. Parker, M. Coleman, P. J. Roberts-Thomson, and M. J. Ahern
Treatment-induced remission in rheumatoid arthritis patients is characterized by a reduction in macrophage content of synovial biopsies
Rheumatology, April 1, 2001; 40(4): 367 - 374.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
P P TAK
Analysis of synovial biopsy samples: opportunities and challenges
Ann Rheum Dis, December 1, 2000; 59(12): 929 - 930.
[Full Text]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.