Hi Cathryn
We had a patient like this earlier this year - he turned out to have
pyodermic gangrenosum, which is known to be associated with RA. His lesions
sound just like your patient's and were in fact microinfarcts with acute
inflammation and pus formation. It may be a good idea for the
histopathologists to look for this?
Cheers
Avril
Avril Wayte
Clinical Chemistry
Ysbyty Gwynedd
Bangor
North Wales
-----Original Message-----
From: Corns, Cathryn [mailto:[log in to unmask]]
Sent: 15 December 2004 10:21
To: [log in to unmask]
Subject: Apolipoproteins and foam cells
Help please!
We have a patient with RA who has developed odd subcutaneous lumps,
containing viscous and nasty-looking pus-like material. The
histologists reported that this contained cholesterol crystals. We
cannot analyse the 'fluid' as it proved impossible to obtain any
supernatant for analysis. A subsequent sample was reported as
containing large numbers of foam cells. The lady has entirely normal
serum lipids.
Our rheumatologist has asked us to analyse this lady's lipoproteins to
see if she could have an abnormal/null form of Apo E that acts as a
potent conversion inducer of macrophages to foam cells.
Has anyone come across this? Can anyone suggest which tests might be
useful?
Cathryn Corns
Head of Biochemistry & Clinical Director
Southend Hospital NHS Trust
01702 435555 ext 4058
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