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Articular Manifestations of Systemic Lupus Erythematosus

RUSSELL LABOWITZ, M.D.; and H. RALPH SCHUMACHER JR., M.D.
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Supported by grants from the Veteran's Administration, Washington, D.C., and the Eastern Pennsylvania Chapter of the Arthritis Foundation, Philadelphia, Pa.; and grant 5Mo1RR40 from the Clinical Research Center, Division of Research Resources, National Institutes of Health, Bethesda, Md.

▸Requests for reprints should be addressed to H. Ralph Schumacher, Jr., M.D., 206 Maloney Building, Hospital of the University of Pennsylvania, 36th & Spruce Sts., Philadelphia, Pa. 19104


Philadelphia, Pennsylvania


Ann Intern Med. 1971;74(6):911-921. doi:10.7326/0003-4819-74-6-911
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We have studied 25 patients with classical systemic lupus erythematosus and joint manifestations to characterize features of the arthritis that may suggest this diagnosis. Objective arthritis was seen in 19 patients (76%) and was usually mild. There was no destructive joint disease except for 4 patients who developed aseptic necrosis while on corticoid therapy. Synovial fluids showed less intense inflammation than in rheumatoid arthritis and did not always reflect the degree of inflammation that was occurring in the synovial membrane. Antinuclear factors, lupus erythematosus cells, and lowered total hemolytic complement were seen in some effusions. Light and electron microscopy of synovial biopsies from 7 patients showed synovial lining cell proliferation and microvascular changes including occasional vasculitis and various degrees of inflammatory cell infiltration. Microtubular paramyxovirus-like inclusions were seen in venular endothelial cells of two patients. Small vessel changes appear to be playing an important role in the pathogenesis of the articular disease.

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