Skip to main content
SpringerLink
Log in

Platelets in the synovial fluid of patients with rheumatoid arthritis

  • Originals
  • Published:
Rheumatology International Aims and scope Submit manuscript

Summary

In a study of synovial fluid from 110 patients with various forms of arthritis, platelets were identified in the synovial fluid of all the 50 rheumatoids, in 18 out of the 25 (72%) with osteoarthritis and in all 35 of those with other forms of inflammatory osteoarthrosis. Identification of platelets by light microscopy was confirmed by electron microscopy. Platelet counts were significantly higher in rheumatoid fluid (mean 14 988/mm3; range 1000–65 000/mm3) compared with fluid from patients with osteoarthrosis (mean 1592/mm3; 0–10 000/mm3). In addition, significantly higher platelet counts were found in the synovial fluid (SF) of inflamed joints. There was a positive correlation between the SF platelet count and the total white cell count, polymorph count, hydrogen ion concentration, knee score, acid phosphatase and 5-nucleotidase activity and a negative correlation with the glucose level. All these factors indicate joint activity. Finally, platelet numbers correlated with SF levels of immunoglobulin M, and seropositive patients had significantly higher platelet counts in the SF compared with seronegative patients. Rheumatoid patients with thrombocytosis also had higher SF platelet counts. The close relationship of the SF platelet count to other indices of inflammation supports the concept that platelets may directly contribute to synovial inflammation by a variety of pathways.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Walsh PN (1975) The possible role of platelet coagulant activities in the pathogenesis of venous thrombi. Thromb Diath Haemorrh (Stuttg) 33:435

    Google Scholar 

  2. Silver MJ, Smith JB, Ingerman CM (1974) Blood platelets and the inflammatory process. Agents Actions 4:233–240

    Google Scholar 

  3. Conn DL, McDuffie FC, Kazmier FJ, Schroeter AL, Sun NCJ (1976) Coagulation abnormalities in rheumatoid disease. Arthritis Theum 19:1237–1243

    Google Scholar 

  4. Jorgansen L, Hovig T, Rowsell HC, Mustard JF (1970) ADP induced platelet aggregation and vascular injury in swine and rabbits. Am J Pathol 61:161–176

    Google Scholar 

  5. Henson PM (1970) Release of vasoactive amines from rabbit platelets induced by sensitized mononuclear leukocytes and antigen. J Exp Med 131:287–306

    Google Scholar 

  6. Henson PM (1970) Mechanisms of release of constituents from rabbit platelets by antigen-antibody complexes and complement. J Immunol 105:476–501

    Google Scholar 

  7. Mustard JF, Packham MA (1968) Platelet phagocytosis. Ser Haematol 1:168

    Google Scholar 

  8. Nachman RL (1978) The platelet as an inflammatory cell. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New York

    Google Scholar 

  9. Henson PM, Spiegelberg HL (1973) Release of serotonin from human platelets induced by aggregated immunoglobulins of different classes and subclasses. J Clin Invest 52:1282–1288

    Google Scholar 

  10. Caygill JC, Pitkeathky DA (1966) A study of β-acetylglucosaminase and acid phosphatase in pathological joint fluids. Ann Rheum Dis 25:137–144

    Google Scholar 

  11. Jasani MK, Katori M, Lewis GP (1969) Intracellular enzymes and kinin enzymes in synovial fluid in joint disease. Ann Rheum Dis 28:497–512

    Google Scholar 

  12. Farr M, Kendall MJ, Shuttleworth R, Meynell MJ, Hawkins CF (1973) Source and significance of 5-nucleotidase in synovial fluid. Ann Rheum Dis 32:326–330

    Google Scholar 

  13. Selroos O (1972) Thrombocytosis in rheumatoid arthritis. Scand J Rheumatol 1:136–140

    Google Scholar 

  14. Hutchinson RM, Davis P, Jayson MIV (1976) Thrombocytosis in rheumatoid arthritis. Ann Rheum Dis 35:138–142

    Google Scholar 

  15. Farr M, Scott DL, Constable T, Hawker RJ, Hawkins CF (1981) Platelets and rheumatoid arthritis. Ann Rheum Dis 40:617

    Google Scholar 

  16. Endresen GKM (1981) Investigation of blood platelets in synovial fluid from patients with rheumatoid arthritis. Scand J Rheumatol 10:204–208

    Google Scholar 

  17. Ropes MW, Bennet GA, Cobb S, Jacox R, Jesser RA (1959) Diagnostic criteria for rheumatoid arthritis, 1958 revision. Ann Rheum Dis 18:49–53

    Google Scholar 

  18. Spurr R (1969) A low viscosity epoxy resin embedding medium for electron microscopy. J Ultrastruct Res 26:31–43

    Google Scholar 

  19. Roy GV, Brewer ME, Hayden JE (1971) Sodium thymolphthalein monophosphatate: a new acid phosphate substrate with greater specificity for the prostatic enzyme in serum. Clin Chem 17:1093–1102

    Google Scholar 

  20. Persijn JP, Slik W Van der, Kramer K, Ruitjet CA de (1968) A new method for the determination of serum nucleotidase. Z Klin Chemie 6:441–446

    Google Scholar 

  21. Chayen J, Bitensky L (1971) Lysosomal enzymes and inflammation with particular reference to rheumatoid diseases. Ann Rheum Dis 30:522–536

    Google Scholar 

  22. Janoff A (1975) At least three human neutrophil lysosomal proteases are capable of degrading joint connective tissues. Ann NY Acad Sci 256:402

    Google Scholar 

  23. Ropes MW, Bauer W (1953) Synovial fluid changes, Harvard University Press, Cambridge, Mass, pp 24, 67

    Google Scholar 

  24. Farr M, Kendall MJ, Bold AM, Hawkins CF (1981) Significance of pH in synovial fluid. Ann Rheum Dis 40:621

    Google Scholar 

  25. Kushner I, Somerville JA (1971) Permeability of human synovial membrane to plasma proteins: relationship to molecular size and inflammation. Arthritis Rheum 14: 560–570

    Google Scholar 

  26. Pfueller SL, Weber S, Lüscher EF (1977) Studies of the mechanism of the human platelet release reaction induced by immunologic stimuli. III. Relationship between the binding of soluble IgG aggregates to the Fc receptor and cell response in the presence and absence of plasma. J Immunol 118:514–524

    Google Scholar 

  27. Cheng CM, Hawiger J (1979) Affinity isolation and characterisation of immunoglobulin G Fc fragment binding glycoprotein from human blood platelets. J Biol Chem R54: 2165

    Google Scholar 

  28. Lüscher EF, Pfueller SL (1978) Platelets as a target of immunologic reactions. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New York, pp 261–268

    Google Scholar 

  29. O'Brien JR (1968) Effect of anti-inflammatory agents on platelets. Lancet I:894

    Google Scholar 

  30. Copley AL (1978) Platelets and physiological defence mechanisms. In: Gaetano G de, Garattini S (eds) Platelets: a multidisciplinary approach. Raven Press, New York, pp 161–197

    Google Scholar 

  31. Zvaiffer NJ (1974) An extravascular immune complex disease. Arthritis Rheum 17:297–305

    Google Scholar 

  32. Mustard JF, Movat Hz, Macmorine DRL, Sényi A (1965) Release of permeability factors from the blood platelets. Proc Soc Exp Biol Med 119:988–991

    Google Scholar 

  33. Smith JB, Ingerman C, Koesis JJ, Silver MJ (1973) Formation of prostaglandins during the aggregation of human blood platelets. J Clin Invest 52:965–969

    Google Scholar 

  34. Nachman RL, Ferris B (1968) Studies on human platelet protease activity. Clin Invest 47:2530–2540

    Google Scholar 

  35. Mills DCB, Robb IA, Roberts GCK (1968) The release of nucleotides, 5HT, and enzymes from human blood platelets during aggregation. J Physiol 195:715–729

    Google Scholar 

  36. Chelsney C, Harper E, Colman RW (1974) Human platelets collagenase. J Clin Invest 53:1647–1654

    Google Scholar 

  37. Legrand Y, Pignaud G (1975) Human blood platelet elastase and proelastase. Pathol Biol 23:546

    Google Scholar 

  38. Weksler BB, Coupal CE (1973) Platelet-dependent generation of chemotactic activity in serum. J Exp Med 137:1419–1430

    Google Scholar 

  39. Yeatts RP, Turner R, Collins R, Kaufmann J, Mashburn H (1978) Soluble and insoluble immune complex-platelet interactions in rheumatoid inflammation. Ann Rheum Dis 37: 421–427

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Investigative Pathology and Rheumatology, The Medical School, The University of Birmingham, B15 2TJ, Birmingham, UK

    M. Farr, A. Wainwright, M. Salmon, C. A. Hollywell & P. A. Bacon

Authors
  1. M. Farr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Wainwright
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Salmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. A. Hollywell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. A. Bacon
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Farr, M., Wainwright, A., Salmon, M. et al. Platelets in the synovial fluid of patients with rheumatoid arthritis. Rheumatol Int 4, 13–17 (1984). https://doi.org/10.1007/BF00683878

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00683878

Key words

Search

Navigation