Objectives Laboratory synovial fluid (SF) tests are often held for joints condition, stage and acuteness of the inflammatory processes estimation. Immunological exams of SF is not routine procedure in clinical practice. We have studied the opportunity of immunological tests used in diagnostics of rheumatoid arthritis (RA).
Methods 44 patients (24 females and 20 males) with RA, diagnosed according to the American Colleges of Rheumatology criteries (1987) were examined. 29 of them have been seropositive. SF was taken by standard knee arthrocentesis. An immunological SF testing included determination of the levels of immunoglobulins A, M, G(IgA, IgM, IgG); C-reactive protein; circulating immune complex; complement proteins; interleukin-1beta (IL-1beta) and tumour necrosis factor alpha TNF-alpha); rheumatoid factor (RF); phagocyte activity tests. These parameters were also determined in the venous blood of the RA patients.
Results In patients with RA the significant increasing of SF immunoglobulins, especially IgG, circulating immune complexes, complement proteins, IL-1 beta and TNF-alpha was found. C-reactive protein was relatively low. There was no significant serum IgG, phagocyte activity, IL-1 beta and TNF-alpha elevation. RF at the RA onset was higher in SF, than in serum. In RA seronegative patients was determined exclusively in the SF in low quantity.
Conclusion We concluded that immunological investigation of SF is important tool for RA diagnosis, especially in activity processes estimation.
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