RESUMEN
The suggestion that the intestinal mucosa may be abnormally permeable and a site of absorption of antigens in rheumatoid arthritis was tested by the use of a 51Cr-EDTA (edetic acid) absorption test. 24 patients with rheumatoid arthritis excreted significantly more 51Cr-EDTA than did 34 controls. Intestinal permeability was normal in untreated patients but almost invariably abnormal in patients treated with non-steroidal anti-inflammatory drugs. Studies in patients with osteoarthritis showed that the permeability abnormalities were due to an effect of NSAIDs on both the proximal and the distal intestine and that the effect was systemically mediated. Indium-111-labelled leucocyte scans showed ileocaecal inflammation in 6 of 9 patients on or recently on NSAIDs. Although increased intestinal permeability does not seem to be important in the pathogenesis of rheumatoid arthritis, the administration of NSAIDs may lead to loss of intestinal integrity, thus facilitating antigenic absorption and perhaps contributing to persistence of the disease.
Asunto(s)
Antiinflamatorios/uso terapéutico , Artritis Reumatoide/metabolismo , Mucosa Intestinal/metabolismo , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/tratamiento farmacológico , Radioisótopos de Cromo , Ácido Edético , Humanos , Indio , Inflamación/diagnóstico por imagen , Inflamación/metabolismo , Mucosa Intestinal/diagnóstico por imagen , Leucocitos , Osteoartritis/diagnóstico por imagen , Osteoartritis/tratamiento farmacológico , Osteoartritis/metabolismo , Permeabilidad , Radioisótopos , CintigrafíaRESUMEN
Mycoplasmas were not isolated from synovial fluid or membrane specimens taken from 41 patients suffering from inflammatory polyarthritis. However, Mycoplasma pneumoniae was isolated in two laboratories and on two occasions from the knee joint of a hypogammaglobulinaemic patient with a chronic polyarthritis.