SUMMARYFive (8.5 per cent) of 59 adult patients with cystic fibrosis described a characteristic arthropathy which was episodis, self-limiting and polyarticular, affecting large and small peripheral joints without evidence of progression to joint damage. The five patients with arthropathy did not differ from the remaining 54 with respect to manifestations of cystic fibrosis. Synovial fluid obtained from two patients during acute episodes was clear, viscous and contained no cells. Biopsies of synovial membrance from the same patietns demonstrated prominent congested blood vessles with some synovial oedma, but no evidence of inflammation. Immunofluorescent staining of synovial membrance demonstrated characteristic initimal deposition of immunoglobulin in the vessles. In one of the two patients acute arthropathy was accompained by transient cutaneous vasculities, circulating immune complexes and lowered serum complement levels, which suggests that the episodic arthropathy in at least some patients with cystic fibrosis is mediated by an immune mechanism.
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