A case of spontaneous femoral neck fracture associated with multicentric reticulohistiocytosis: oversecretion of interleukin-1beta, interleukin-6, and tumor necrosis factor alpha by affected synovial cells

Arthritis and Rheumatism
H NakamuraS Katsumata

Abstract

We describe a case of left femoral neck fracture associated with multicentric reticulohistiocytosis (MR). Biopsy specimens from a skin nodule and from synovial tissue showed histiocytic multinucleated giant cells (MR cells) that are characteristic of MR. A surgical specimen from the resected femoral head revealed that multinucleated giant cells and mononuclear cells invaded the marginal subchondral bone, without evident pannus. These cells also infiltrated into the fracture site, with bone resorption by activated osteoclasts. Immunohistochemical studies of synovium from the left hip joint showed positive staining for interleukin-1beta (IL-1beta), IL-6, and tumor necrosis factor alpha, and abundant cytokine production by cultured synovial cells was demonstrated. These findings suggest that the subchondral invasion and intramedullary infiltration by MR cells caused articular destruction and/or fracture as a result of oversecretion of the cytokines.

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Citations

Oct 10, 2009·Pediatric Rheumatology Online Journal·Catalina MatizCatherine April Bingham
Oct 7, 2006·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Chun-Hsiung ChenHsiao-Yi Lin
Jan 18, 2018·Arthritis Care & Research·Sean B SingerJohn T O'Malley
Feb 7, 2003·Journal of Pediatric Hematology/oncology·Paul T Jubinsky
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Apr 23, 2015·Current Rheumatology Reports·Carlo SelmiM Eric Gershwin

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