[Clinico-morphological comparisons in variants of rheumatoid arthritis (based on the data of puncture biopsy of synovial membrane)].

Altogether 564 successive puncture biopsies withdrawn from patients with different versions of RA were subjected to morphological study with the aid of a statistical analysis of the intensity of 25 signs of synovitis evaluated according to the 5-score system. The differences in the structure of synovitis were recognized: predominance of the signs of the humoral immunity (particularly plasma cell infiltration) in patients with a mild (with a favourable evolution) version of RA and predominance of the signs of the cell-mediated immunity (macrophagal and T-lymphocyte infiltration, cytolysis, proliferation and mesenchymal transformation of fibroblasts) in a grave (incurable, invalidism-producing) version. The disease of medium gravity (running a progressive course but relatively eliminated by therapy) was characterized by the combination of and undulatory time course of the signs indicated. The greatest involution of the majority of the synovitis signs as influenced by the treatment was observed in a mild, whereas the least in the grave version of RA. It is suggested that local antibody genesis may play a protective role in RA.