中國人類風濕關節炎皮下結節與免疫遺傳之研究

類風濕關節炎是以慢性關節發炎為主的疾病，關節外的臨床表徵－皮下結節之發生率在歐美報告約為20－40%。為了瞭解中國人類風濕關節炎皮下結節之發生率，臨床特徵，病理變化與遺傳之關係等，我們針對本科94例類風濕關節炎患者作了上述之研究。結果顯示，7例（7.45%）有皮下結節，結節較小，多在肘鷹嘴突附近，其中1例合併粘液囊炎，病理切片僅1例為典型之類風濕肉芽腫，其餘皆為含少量發炎細胞或血管之纖維組織，淋巴表面抗原DR4在類風濕關節炎患者有顯著地增加，但無法證實與皮下結節有特定之關係。上述發現與國外白種人之皮下結節，如發生率，大小，病理組織皆有不同，顯示雖DR4與國外報告相似，但相信尚有其它的基因，或環境因素，如感染、食物、外傷等，可影響疾病的發生及臨床表現的不同。

關鍵字

類風濕關節炎皮下結節； HLA-DR抗原

並列摘要

Rheumatoid arthritis (RA) is an inflammatory disease that mainly involve synovial joints. The subcutaneous nodule, one of the extra-articular manifestations, occurred in 20 to 40% of Caucasian with RA. To explore the frequency, character, and pathology of subcutaneous nodule and immunogenetic aspects in RA, 94 definite cases were enrolled into our studies. We demonstrated 7 cases had subcutaneous nodule; most of them were smaller in size and located around olecranon area and one complicated with olecranon bursitis. Only 1 of 7 biopsy specimens showed typical rheumatoid granuloma, the rest showed granulation tissue. HLA-DR4 was significantly increased in our RA cases when compared to healthy people but no conclusion can be made between HLA-DR and subcutaneous nodule. Despite the same frequency of HLA-DR4 between Chinese and Caucasian, the different manifestations of subcutaneous nodule in those 2 groups of people suggest there are other HLA genes or environmental factors may give rise to the clinical and pathologic varieties of RA.

並列關鍵字

Rheumatoid arthritis ； Subcutaneous nodule ； Rheumatoid factor ； HLA-DR antigen

國際替代計量

中國人類風濕關節炎皮下結節與免疫遺傳之研究

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