Gonococcal arthritis–dermatitis syndrome. study of serum and synovial fluid immune complex levels

Abstract

Immune complexes from serum and synovial fluid were detected by the Clq binding assay in 12 patients with disseminated gonococcal infection. Since immune complexes were regularly higher in synovial fluids than in paired sera and were not detected by the monoclonal rheumatoid factor radioimmunoassay, we suggest that IgM may be present in these complexes and that this represents a primary immune response. In contrast, only 2 of 10 patients with local gonococcal infection were slightly positive both with the Clq assay and the monoclonal rheumatoid factor assay. In patients with disseminated gonococcal infection, immune complexes closely paralleled the disease activity and negatively correlated with complement levels. Synovial fluid immune complexes seem to occur in the early and aseptic phase of polyarthritis and to aid the entrance of circulating gonococcal organisms. From the results of our study, it seems that immunologic processes initiate and/or sustain inflammation in disseminated gonococcal infections that appear, at least in part, as a form of reactive arthritis.Arthritis is a cardinal manifestation of disseminated gonococcal infection and is often the major From the Free University of Brussels, Belgium.

Immune complexes in synovial fluid and serum from patients with disseminated gonococcal infection: evidence for local immune complex formation within the joint.

“…Correspondence to Dr Brian S Andrews, Division of Rheumatology and Clinical Immunology, Medical Sciences I, Department of Medicine, University of California, Irvine, CA 92717, USA. antibody with the formation of in situ IC. '6 As the SF from patients with active synovitis and documented extrasynovial gonococcal infection is often sterile it has been suggested that the arthritis may be a manifestation of a systemic IC disease.6 [17][18][19][20] Complexes have been reported in serum and SF in DGI using the Raji cell radioimmunoassay, the Clq binding assay, and the platelet aggregation assay. 18 20 When a monoclonal rheumatoid factor assay is employed or cryoglobulins are measured, however, the presence of IC has not been shown.…”

“…18 20 When a monoclonal rheumatoid factor assay is employed or cryoglobulins are measured, however, the presence of IC has not been shown. 19 20 No correlation has been observed between the IC found in serum and SF.20…”