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[The diagnostic value of so-called Reiter cells in joint effusions]
Abstract:
In 1967, Pekin, Malinin and Zvaifler described macrophages with one or more phagocytized granulocytes. These authors declared these cell phagocytes as a characteristic cytologic sign of Reiter's syndrome. Because we could observe this phenomenon in other joint diseases, too, we studied systematically different inflammable and non-inflammable joint effusions for the diagnostic value of these cells. We counted 1,000 cells in each joint effusion and determined the numbers of phagocytizing and the numbers and sorts of phagocytized cells and heterophagic vacuoles with cell fractions, respectively. We concluded that, beside the Reiter's syndrome, other inflammatory joint diseases had these cell changes, too, especially joint effusions in juvenile rheumatoid arthritis. In the other cases we found a reduced number of phagocytizing and phagocytized cells only. Cell phagocytes, including synovial lining cells, are obviously characteristic for early phases of chronic inflammatory or transitory joint diseases with joint effusions. However, cell phagocytes are not a proof for the diagnosis of Reiter's syndrome in joint effusions.
Insights
Cell phagocytes, macrophages engulfing granulocytes, are not exclusive to Reiter's syndrome. These cells appear in various inflammatory joint diseases, including juvenile rheumatoid arthritis, indicating early-stage inflammation.
Area of Science:
- Rheumatology
- Cell Biology
- Pathology
Context:
- Macrophages with phagocytized granulocytes were initially identified as a hallmark of Reiter's syndrome.
- The presence of these 'cell phagocytes' in other joint conditions prompted further investigation into their diagnostic utility.
Purpose:
- To systematically evaluate the diagnostic value of cell phagocytes in various inflammatory and non-inflammatory joint effusions.
- To determine if cell phagocytes are specific to Reiter's syndrome or indicative of other joint diseases.
Summary:
- Analysis of joint effusions revealed cell phagocytes in conditions beyond Reiter's syndrome, notably in juvenile rheumatoid arthritis.
- A reduced presence of phagocytizing and phagocytized cells was observed in other cases.
- Cell phagocytes, including synovial lining cells, are characteristic of early-stage chronic or transient joint diseases with effusions.
Impact:
- Challenges the specificity of cell phagocytes for diagnosing Reiter's syndrome.
- Highlights the potential role of cell phagocytes as indicators of early-phase inflammatory joint conditions.
- Suggests a broader diagnostic context for interpreting the presence of cell phagocytes in synovial fluid analysis.