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Increased cellularity and expression of adhesion molecules in muscle biopsy specimens from patients with rheumatoid arthritis with clinical suspicion of vasculitis

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The sensitivity for the diagnosis vasculitis is limited (13owing to the segmental distribution of the histological abnormalities and, usually, the restricted organ involvement.12 The diagnostic yield of muscle samples can be improved by examining multiple biopsy sections and by using new diagnostic criteria for vasculitis, such as the presence of perivascular infiltrates of more than three cell layers. Firstly, patients without any clinical sign of https://www.canadagooseonlineshop.co.uk vasculitis were included. In this so called “RA” group the mean age of the six patients with RA was 72 years, with a mean disease duration of 12 years. Rheumatoid factors were detectable in five out of six, all had erosive disease, and none had subcutaneous nodules. Four of the patients in this group were treated with disease modifying antirheumatic drugs (DMARDs) (three sulfasalazine, one methotrexate) and one patient used prednisone (13 mg/d).

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The extra articular manifestations of RA were mainly nailfold lesions, purpura, cutaneous ulcers, and distal sensorimotor or sensory polyneuropathy. Weight loss was a common extra articular feature, but it was almost always accompanied by other extra articular manifestations of RA. Table 1 gives details of the extra articular manifestations of the individual patients. In addition to the RA control group, five patients with osteoarthritis (OA) with a mean age of 67 years were recruited.

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canada goose uk outlet Characteristics of the individual patients with rheumatoid arthritis (RA) and extra articular manifestations, including the sites at which biopsy samples were taken and whether vasculitis was present (+) or absent () in these specific histological samplesPatients with RA were assigned to the different subgroups according to the results of an extensive conventional histological investigation on paraffin embedded tissue before, canada goose outlet official and independently of, the immunohistological analysis on frozen sections, which is the subject of this study.14 For this purpose a full thickness (skin/muscle/fascia) biopsy specimen of the quadriceps muscle was examined in all patients. Quadriceps muscle biopsy samples in the control groups were obtained during surgery for total hip replacement or knee arthroplasty. In most of the patients with RA suspected of vasculitis an additional tibial muscle biopsy specimen was examined (table 1). canada goose uk outlet

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