Coexistent rheumatoid arthritis and chronic tophaceous gout

Jessee, E.Forrest; Toone, Elam C.; Owen, Duncan S.; Irby, Robert

doi:10.1002/art.1780230217

Cited by 14 publications

(3 citation statements)

References 5 publications

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“…9 Contaminating red cells were lysed by a five minute incubation in Gey's solution and the preparation adjusted to 5x I09 neutrophils/l in Eagle's minimal essential medium (MEM, Flow Laboratories) containing 1% fetal calf serum. CRYSTALS MSU crystals were prepared under sterile conditions by the method of Denko and Whitehouse20 and the supersaturated solution autoclaved before crystallisation.…”

Section: Materials and Methods N Eutroph I Lsmentioning

confidence: 99%

“…[7][8][9] Possible reasons for the mutual exclusion between these diseases have been reviewed elsewhere.1 10 and include an anti-inflammatory or immunosuppressive effect of hyperuricaemia,"'-4 inhibition of crystal deposition by possible connective tissue alterations in RA,'5 diagnostic difficulty, synovial hypocomplementaemia,l and impaired phagocytic function of neutrophils in rheumatoid joint fluid. 16 17 It has also been proposed that coating of MSU by RF may inhibit the activation of cellular or fluid-phase mediators of inflammation by the crystal surface.'…”

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confidence: 99%

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Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis.

Gordon¹,

Ahern²,

Reid³

et al. 1985

Annals of the Rheumatic Diseases

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SUMMARY Gout and classical rheumatoid arthritis rarely coexist. We report a patient with strong evidence for both these diseases. Possible reasons for the negative correlation between these diseases are summarised. One hypothesis suggests inhibition of surface activity of monosodium urate crystals (MSU) by binding of rheumatoid factor (RF). This was studied with a purified monoclonal rheumatoid factor (mRF) with specificity for IgG. The mRF bound preferentially to MSU coated with IgG in contrast with the IgM control. Inhibition of the neutrophil chemiluminescence (CL) response to IgG-coated MSU was observed at concentrations of mRF that had no effect on the CL response to uncoated crystals. Neutrophil activation was not altered by coating crystals with an IgM control at the same concentration. These data suggest that RF may bind to antigenic determinants on exposed Fc of adsorbed IgG and block the interaction of crystal-bound IgG with Fc receptors. Although crystal coating by RF may modify the expression of gouty arthritis, it is unlikely to be the sole explanation for the dissociation between gout and RA.The negative correlation between gout and rheumatoid arthritis (RA) is widely accepted, but the reason(s) are unclear.1 Since s3ynovial thickening,2 symmetrical joint involvement, a low titre rheumatoid factor4 (RF), joint erosions,5 and similar histopathological changes in the synovial membrane6 can occur in both conditions, proof of the coexistence of gout and RA requires the demonstration of monosodium urate crystals (MSU), a high titre RF, and histological evidence of a rheumatoid nodule in an alcohol-fixed specimen.7-9Possible reasons for the mutual exclusion between these diseases have been reviewed elsewhere.

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Section: Materials and Methods N Eutroph I Lsmentioning

confidence: 99%

mentioning

confidence: 99%

Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout and rheumatoid arthritis.

Gordon¹,

Ahern²,

Reid³

et al. 1985

Annals of the Rheumatic Diseases

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show abstract

“…Coexistent gout and rheumatoid arthritis (RA) have recently been the subject of two case reports and literature reviews (1,2). In none of the reported cases has the patient received prolonged allopurinol therapy.…”

Section: To the Editormentioning

confidence: 99%