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Iron deposits and catabolic properties of synovial tissue from patients with haemophilia

G. Roosendaal, MD1; M. E. Vianen, BA, Technician2; M. J. G. Wenting, BA, Technician2; A. C. van Rinsum, MD, PhD3; H. M. van den Berg, MD, PhD1; F. P. J. G. Lafeber, BA, PhD2; and J. W. J. Bijlsma, MD, PhD, Professor2

1 Van Creveld Clinic, National Haemophilia Centre
2 Department of Rheumatology and Clinical Immunology
3 Department of Orthopaedic Surgery, University Hospital Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.

Correspondence should be sent to Dr G. Roosendaal.

Haemophilic arthropathy is characterised by iron deposits in synovial tissues. We investigated the suggestion that iron plays an important role in synovial changes.

We obtained synovial tissue from six patients with haemophilia during arthroplasty, finding that brown haemosideritic tissue was often adjacent to tissue with a macroscopically normal appearance in the same joint. Samples from both types of synovial tissue were analysed histologically and biochemically to determine catabolic activity. Macroscopically haemosideritic synovium showed a significantly higher inflammatory activity than that with a normal appearance. Cultures of abnormal synovial tissue gave a significantly enhanced production of IL-1, IL-6 and TNF{alpha} compared with cultures of synovial tissue with a normal appearance. In addition, the supernatant fluids from the cultures showed greater catabolic activity from haemosideritic tissue, as determined by the inhibition of the synthesis of articular cartilage matrix.

We conclude that in patients with haemophilic arthropathy, local synovial iron deposits are associated with increased catabolic activity.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General