慢性関節リウマチにおける関節液の細胞学的検討

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  • Cytology of synovial fluid in rheumatoid arthritis: A light, immunofluorescence and electron microscope study.

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Synovial fluid from 21 patients with rheumatoid arthritis was examined cytologically and the findings were compared with the results of immunofluorescent and electronmicroscopic observation.<BR>The results were summarized as follows:<BR>1) The Fluid appeared yellowish-white or yellowishbrown and its viscosity was lower than normal. The number of mono or polynuclear cells varied from 3, 600 to 54, 200 per ml. The predominant cell in all preparations was mature polymorphonuclear granulocyte with usual appearance and accounted for 73% of all nucleated cells. The remaining cells consist of lymphocyte (5%) and monocyte-like cell (21%).<BR>2) RA cell (ragocyte) in the synovial fluid, called by Hollander, were seen in all cases and the proportion of RA cell varied from 28 to 90% of cells counted.<BR>3) Immunofluorescence microscopy showed a granular pattern for IgG and the complement in the cytoplasma of neutrophil and monocyte-like cell about 83 percent of 12 cases. IgM was positive in 67%.<BR>4) At the electron microscopic levels, neutrophils and monocyte-like cells were observed and the organelle befitting the inclusions of the RA cell were lipid, phagosome and phagolysosome. It was suggested that the phagolysosome among those organelle consisted of immunocomplex.

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