Ultrastructure of the Synovial Microvasculature in Rheumatoid Arthritis (ra) and Systemic Lupus Erythematosus (SLE)
Synovial vascular alterations have been suggested to be important in the pathogenesis of both RA and SLE (1). Although vascular changes have been described by light microscopy the presence of significant ultrastructural changes has been questioned (2). This report describes an EM study of needle synovial biopsies from 5 patients each with classical RA and SLE. Specimens were promptly fixed in Karnovsky's paraformaldehyde-glutaraldehyde diluted 1:1 with 0.1 M cacodylate buffer at pH 7.4, washed in buffer, post-fixed in Palade's osmium-veronal, dehydrated with alcohol, embedded in epon, cut, and stained with lead citrate and uranyl acetate. Vascular changes were seen in both groups with some findings common to both diseases. Basement membranes were multilaminated. (Fig.l). This was not seen in normal rabbits and monkeys but was also present in other human joint diseases including degenerative arthritis. Venular endothelium was active appearing with filopodia extending into the lumen and with gaps demonstrable between endothelial cells (Fig.2,3). Platelets occluded some gaps (Fig.2).