Seasonal variation and disease distribution of cytophagocytic mononuclear cells in synovial fluid: A medical record study

Cytophagocytic mononuclear (CPM) cells, previously known as Reiter's cells, are macrophages containing apoptotic polymorphonuclear leucocytes. Although they can be found in synovial fluid (SF) from different arthropathies, their role remains unclear. This study was performed to determine the frequency and disease distribution of CPM cells in SF in a large cohort of patients with rheumatic diseases over a 12-year period. We also investigated the seasonal variation in their incidence. This record review study included the reports pertaining to SF analyses performed between January 2010 and December 2021. Data were retrieved from the charts of inpatients and outpatients at Rheumatology and Emergency Departments of Padova. The total number of SF samples containing CPM cells was 189: 69% was from patients with seronegative spondyloarthritis (SpA), thus indicating a strong association between CPM cells and SpA. SF samples containing CPM cells were predominantly inflammatory. Our analyses demonstrated a 6-month cyclical fluctuation in concentrations of CPM cells, with an increase in spring and autumn. The presence of CPM cells in SF might offer diagnostic insight into the definition of SpA. Further studies are warranted to ascertain the link between CPM cells and the apoptotic process, shedding light on the mechanisms leading to their formation.

Automated summary

This study investigated the frequency and disease distribution of cytophagocytic mononuclear (CPM) cells in synovial fluid of patients with rheumatic diseases over a 12-year period. The results showed a strong association between CPM cells and seronegative spondyloarthritis (SpA), with a seasonal variation in their incidence, peaking in spring and autumn. This suggests that the presence of CPM cells in synovial fluid may offer diagnostic insights into SpA.