Cytomorphological, ultrastructural and immunological characteristics of the ovialsyn fluid in seropositive rheumatoid arthritis.

Experiments have been performed on 15 samples of synovial fluid (SF) from patients with seropositive rheumatoid arthritis (RA) (Latex 1/280 and Waaler Rose 1/1024) versus 10 SF samples from patients with hydroarthrosis, used as control. By cytomorphologic studies, we determined the cellularity, ragocytosis and synoviocytogram of the SF cellular pellet and found out that rheumatoid SF is characterized by cytosis (9953/mm3), ragocytosis (70%) and polynucleosis (73%) whereas hydroarthrotic SF is characterized by lymphocytosis (54.6%). Ultrastructurally, rheumatoid SF ragocytes present numerous intracytoplasmic inclusions and phagolysosomes, a fact that certainly evidences an endocytotic activity. At the level degenerative of PMN cells, (6%), the experiments evidenced the presence of some lysis cytoplasmic plateau associated with the absence of cellular organelles, as well as an alteration of the granulofibrillar structure of the nucleus. We also noticed cellular debris consisting of partially destroyed cellular organelles. By immunologic studies we obtained seric pathologic values for CIC (mean = 108.05 U), IgM (mean = 420 Ul/ml), IgG (mean = 355 Ul/ml), anti DNA antibodies (mean = 405 U) and anti collagen II antibodies (mean = 558 U). As regards the seric complement activity of C1q and C3 fractions, it was higher (mean = 18.87 mg% and mean = 109.94 mg%, respectively) than in the SF (mean = 5.78mg% and mean = 30.83 mg%, respectively). Corroborating the cytomorphological, ultrastructural and immunological data, we could better explain the lesional types examined and emphasize the importance of the immunomorphological changes in RA diagnosis.