Extended report
Increased cellularity and expression of adhesion molecules in
muscle biopsy specimens from patients with rheumatoid arthritis with
clinical suspicion of vasculitis, but negative routine histology
Patrick C Verschuerena d, Alexandre E Voskuylb, T J Smeetsc, Koos H Zwindermana, Ferdinand C Breedvelda, Paul P Takc
a Leiden University
Medical Centre, The Netherlands, b Free University
Hospital, Amsterdam, The Netherlands, c Academic Medical Centre, Amsterdam, The
Netherlands, d Universitaire
Ziekenhuizen Leuven, Belgium
Correspondence to: Dr Patrick Verschueren, Department of Rheumatology, Universitaire Ziekenhuizen Leuven, Herestraat 49, B-3000 Leuven, Belgium Email: Patrick.Verschueren{at}uz.kuleuven.ac.be
Accepted for publication 10 April 2000
OBJECTIVE
Histological
analysis of random quadriceps muscle biopsy specimens can be used to
detect vasculitis in patients with rheumatoid arthritis (RA). This
study aimed at determining the immunohistological features in patients
with clinical suspicion of rheumatoid vasculitis, but without a
transmural infiltrate or fibrinoid necrosis of the vessel wall on
routine histology.
METHODSThree groups
of patients with RA were studied: (a)
without clinical signs of vasculitis (n=6);
(b) with recent onset of extra-articular features and a clinical suspicion of vasculitis but normal routine histology (n=11); and (c) with recent onset
of extra-articular features and vasculitis, histologically proved
either in muscle or other biopsy specimens (n=14). A control group of
patients with osteoarthritis was also included (n=5). Frozen sections
from quadriceps muscle biopsy specimens were analysed with monoclonal antibodies to detect CD3, CD4, CD8, CD68, ICAM-1, VCAM-1, and HLA-DR.
The slides were evaluated using a semiquantitative scoring system
(0-4).
RESULTSThe mean
scores gradually increased from group 1 to 3, leading to significant
differences between groups 1 and 2, but not between groups 2 and 3 for
most markers (p< 0.05). Thus the pathological changes were similar for
the two groups with clinical signs of vasculitis, even when the
conventional histological evaluation was negative. Higher
immunohistological scores were associated with perivascular infiltrates
on routine histology.
CONCLUSIONThe
pathophysiological events leading to vasculitis are reflected by
the changes in the quadriceps muscle biopsy specimens. The data
indicate that the sensitivity of examination of muscle biopsy specimens
for the diagnosis of rheumatoid vasculitis can be increased by the use
of new criteria.
© 2000 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Turesson, C., Englund, P., Jacobsson, L. T. H., Sturfelt, G., Truedsson, L., Nennesmo, I., Lundberg, I. E.
(2001). Increased endothelial expression of HLA-DQ and interleukin 1{alpha} in extra-articular rheumatoid arthritis. Results from immunohistochemical studies of skeletal muscle. Rheumatology (Oxford)
40: 1346-1354
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
