Ultrastructural characteristics of the synovial membrane in idiopathic haemochromatosis.

Schumacher, H. Ralph

doi:10.1136/ard.31.6.465

Cited by 53 publications

(10 citation statements)

References 30 publications

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“…In HH, haemosiderin, an intracellular iron storage complex, is found primarily within superficial synovial lining cells, but also in macrophages due to phagocytosis of iron loaded synoviocytes 31 38. In the deeper layers, very little iron can be detected, and only occasionally in macrophages 38…”

Section: Histopathologymentioning

confidence: 99%

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia

et al. 2015

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Joint damage due to (recurrent) joint bleeding in haemophilia causes major morbidity. Although the exact pathogenesis has not been fully elucidated, a central role for iron is hypothesised. Likewise, in hereditary haemochromatosis joint destruction is caused by iron overload. A comparison between these types of arthropathy could provide more insight in the influence of iron in inducing joint damage. A literature review was performed to compare both disorders with respect to their clinical and histological characteristics, and preclinical studies on the influence of iron on different joint components were reviewed. Similarities in the features of arthropathy in haemochromatosis and haemophilia are cartilage degeneration, subchondral bone changes with osteophyte and cyst formation, and osteoporosis. In both disorders synovial inflammation and proliferation are seen, although this is much more explicit in haemophilia. Other substantial differences are the age at onset, the occurrence of chondrocalcinosis radiographically and calcium pyrophosphate dihydrate deposition disease in haemochromatosis, and a rapid progression with joint deformity and neovascularisation in haemophilia. Preclinical studies demonstrate detrimental effects of iron to all components of the joint, resulting in synovial inflammation and hyperplasia, chondrocyte death, and impaired osteoblast function. These effects, particularly the synovial changes, are aggravated in the presence of a pro-inflammatory signal, which is prominent in haemophilic arthropathy and minimal in haemochromatosis. Additional research is needed to further specify the role of iron as a specific target in treating these types of arthropathy.

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Section: Histopathologymentioning

confidence: 99%

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia

et al. 2015

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“…Electron-dense deposits in synovial vessel walls have previously been seen only infrequently and only in inflammatory joint disease such as the arthus reaction of experimental antigen-induced arthritis (21 ), transient undiagnosed arthritis (12), rheumatoid arthritis (22), and gouty arthritis (23). Joint diseases with noninflammatory effusions like those seen in HPO have also been examined, and no electron-dense synovial vascular deposits have been found (24,25). A variety of proteins including hemoglobin, fibrinogen, and even enzymes (26) are electron-dense, and thus conclusions cannot yet be made about the nature of the dense deposits in HPO.…”

Section: Synovial Membrane Electron Microscopy and Implicationsmentioning

confidence: 99%

Articular manifestations of hypertrophic pulmonary osteoarthropathy in bronchogenic carcinoma. A clinical and pathologic study

Schumacher

1976

Arthritis & Rheumatism

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Eight patients with bronchogenic carcinoma presented with painful joint effusions as part of the syndrome of hypertrophic osteoarthropathy. Elevated sedimentation rates and symptomatic relief with aspirin were common, but synovial fluids all had leukocyte counts less than 500/mm3. Synovial microvascular injury was found in all patients, and electron-dense deposits in synovial vessel walls were identified in 5 cases. These vascular deposits suggest a role for circulating materials in pathogenesis.Painful swelling around knees, ankles, wrists, and occasionally fingers may be the presenting manifestation of hypertrophic pulmonary osteoarthropathy (HPO) but can easily be mistaken clinically for rheumatoid arthritis (1,2). Clubbing may be subtle but is rarely absent. Because HPO may be an important early clue to the diagnosis of bronchogenic carcinoma and other pulmonary mass lesions, this report describes 8 cases and emphasizes some characteristics of the arthropathy that should help raise the possibility of a diagnosis of HPO. ~_ _ _ _From the Veterans Administration Hospital and the University of Pennsylvania.

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“…'6 There were some similarities to the synovial biopsy findings in haemochromatosis arthropathy,'7 18 which may have been an aetiological factor in the three patients with a raised serum ferritin concentration and a history of numerous blood transfusions. Whether the synovial haemosiderin deposits in our patients were the result of haemarthrosis or iron overload remains unknown, though both may have been contributory.…”

Section: Discussionmentioning

confidence: 86%

Dialysis arthropathy: amyloid or iron?

Cary¹,

Sethi²,

Ea³

et al. 1986

BMJ

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Ultrastructural characteristics of the synovial membrane in idiopathic haemochromatosis.

Cited by 53 publications

References 30 publications

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia

Articular manifestations of hypertrophic pulmonary osteoarthropathy in bronchogenic carcinoma. A clinical and pathologic study

Dialysis arthropathy: amyloid or iron?

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