Brown J P, Rola-Pleszczynski M, Ménard H A
Arthritis Rheum. 1986 Sep;29(9):1147-51. doi: 10.1002/art.1780290913.
Eosinophilia of synovial fluid is uncommon. Using the identification of Charcot-Leyden crystals to alert for the presence of eosinophils, we have increased by a factor of 5 the detection rate of synovial fluid eosinophilia. We describe here our clinical and laboratory findings in 7 patients with this feature. We believe they constitute a defined syndrome. Typically, the patients were young (ages 18-51) and had a personal and family history of allergy. They developed an acute, painless monarthritis after a minor trauma, and had no concurrent allergic symptoms. Each episode resolved in 1-2 weeks without therapy, and 3 patients had recurrences. All had pronounced dermatographism. The synovial fluid was mildly inflammatory: 10,850 +/- 3,665 white blood cells/mm3, with 41 +/- 5% eosinophils (mean +/- SEM). The cellularity and chemistry of the peripheral blood was unremarkable, except for a mild elevation of IgE levels (370 +/- 104 IU/ml). The exact pathophysiologic mechanism underlying this benign entity is not clear, but we suspect a nonimmunologic triggering event is operant, i.e., synovial trauma which mimics the cutaneous dermatographism.
滑液嗜酸性粒细胞增多并不常见。通过识别夏科-莱登结晶来提示嗜酸性粒细胞的存在，我们将滑液嗜酸性粒细胞增多的检出率提高了5倍。我们在此描述7例具有该特征患者的临床和实验室检查结果。我们认为它们构成了一种明确的综合征。通常，患者较为年轻（年龄18 - 51岁），有个人及家族过敏史。他们在轻微创伤后发生急性、无痛性单关节炎，且无并发过敏症状。每次发作在未经治疗的情况下1 - 2周内缓解，3例患者复发。所有患者均有明显的皮肤划痕症。滑液呈轻度炎症：白细胞计数为10,850 ± 3,665个/mm³，嗜酸性粒细胞占41 ± 5%（均值 ± 标准误）。外周血的细胞成分和化学指标无明显异常，仅IgE水平轻度升高（370 ± 104 IU/ml）。这种良性疾病的确切病理生理机制尚不清楚，但我们怀疑有一个非免疫触发事件起作用，即类似皮肤划痕症的滑膜创伤。
