TY - JOUR T1 - Synovial Biopsy Findings in Arthritis Associated with Hepatitis C Virus Infection JF - The Journal of Rheumatology JO - J Rheumatol SP - 1361 LP - 1363 DO - 10.3899/jrheum.091309 VL - 37 IS - 6 AU - ALEXIS OGDIE AU - H. RALPH SCHUMACHER, Jr AU - LIE DAI AU - LAN X. CHEN AU - EUGENE EINHORN AU - FRANK PESSLER Y1 - 2010/06/01 UR - http://www.jrheum.org/content/37/6/1361.abstract N2 - To the Editor:The worldwide prevalence of arthritis presumed to be due to hepatitis C virus (HCV) infection has been reported between 2.4 million and 45.9 million people1,2. Histopathological changes in HCV-associated synovitis have not been examined. We have performed a histological and immunohistochemical analysis of synovial biopsies from the knee joints of 2 patients with HCV infection and arthritis.Laboratory values are summarized in Table 1. Patient 1 was a 56-year-old African American man with joint pain involving hands, wrists, elbows, shoulders, knees, and ankles of 4 months’ duration. There was no history of sexually transmitted diseases or gastroenteritis in the preceding months. Physical examination revealed warmth, swelling, and tenderness over the elbows, wrists, metacarpals, proximal interphalangeal joints, knees, ankles, and metatarsal bones. A closed-needle synovial biopsy was performed on 1 knee joint. At 3 years’ followup, the patient is maintained on low-dose prednisone and continues to have arthralgias but no overt joint swelling.View this table:In this windowIn a new windowTable 1. Laboratory values.Patient 2 was a 42-year-old white man with a painful right knee effusion of 1 month’s duration. He denied prior trauma or illness, but reported sweats and chills. There was no recent history of sexually transmitted diseases and no gastroenteritis in the months prior. A closed-needle synovial biopsy was performed on the affected knee joint. Symptoms resolved after an intraarticular injection of triamcinolone hexacetonide and subsequent treatment with nonsteroidal antiinflammatory drugs. Two years later the arthritis has not recurred.Synovial tissue sections from both patients were stained with H&E or immunostained for CD15 (neutrophilic granulocytes), CD3, CD20, CD38, CD68, Ki-67, and von Willebrand factor (vWF) … ER -