HISTOLOGICAL-EVALUATION OF DESTRUCTIVE MONOARTHROPATHY IN MIXED CONNECTIVE-TISSUE DISEASE

The synovium from a patient with mixed connective tissue disease and d estructive ankle monoarthritis was studied in detail to determine its immunohistological characteristics. Fibrinoid necrotic tissue on the s urface of the synovium, multi-layered lining cells, increased numbers of capillaries, interstitial edema, infiltration of macrophages, relat ively small numbers of lympho-plasma cells and polymorphonuclear leuko cytes, scattered bone fragments, and multinucleated giant cells were o bserved. Many cells in the lining and sublining area were positive for CD68 and MAC387. Lower layers of increased lining cells which had a s pindle shape were positively stained with anti-HLA-DR antibody. The sm all arteries in the deeper part of the synovium revealed obstruction o r highly stenotic change. These findings suggest that obstructive circ ulatory disturbance due to endothelial injury might influence the prog ression of arthritis.