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ULLA LINDQVIST, GUDJON KRISTJÁNSSON, INGER PIHL-LUNDIN, EVA HAGFORSEN, and GERD MICHAËLSSON ABSTRACT. Objective. To determine if there is evidence of inflammation in the duodenal mucosa in patients with psoriatic arthritis (PsA) and to compare the results with those in patients with psoriasis vulgaris (PsV). Methods. Nineteen consecutive patients with PsA underwent gastroduodenoscopy, and biopsy specimens were taken from the duodenal and gastric mucosa. In addition to routine processing, the duodenal mucosal specimens were stained for CD3+, CD8+ and CD4+ T lymphocytes, tryptase-positive mast cells, and EG2-positive eosinophil granulocytes. The results were compared with those in duodenal mucosal specimens from patients with PsV and patients with irritable bowel syndrome. Results. Compared with PsV patients (without antibodies against gliadin), patients with PsA had a highly significant increase in intraepithelial CD3+ and CD8+ lymphocytes and also in CD4+ lymphocytes in the lamina propria in the villi. The lymphocyte increase was not related to presence of IgA antibodies against gliadin, endomysium, or transglutaminase, or to concomitant gastritis. Patients with PsA and PsV showed a pronounced increase in mast cells and eosinophil granulocytes. Conclusion. The increased lymphocyte infiltration in the duodenal mucosa in PsA, but not in PsV, might indicate different pathogenetic mechanisms in these psoriasis variants. (First Release Mar 15 2006; J Rheumatol 2006;33:924–7) Key Indexing Terms: INTESTINAL INFLAMMATION
From the Section of Rheumatology, Section of Gastroenterology, and Section of Dermato-Venereology, Department of Medical Sciences, University Hospital, Uppsala, Sweden. Supported by grants from the Swedish Psoriasis Association, the E. Welander and Finsen Foundations, the Swedish Medical Society, and the Medical Faculty of the University of Uppsala. U. Lindqvist, MD, Section of Rheumatology; G. Kristjánsson, MD, Section of Gastroenterology; I. Pihl-Lundin, PhD; E. Hagforsen, PhD; G. Michaëlsson, MD, Section of Dermato-Venereology. Address reprint requests to Dr. U. Lindqvist, Section of Rheumatology, Department of Medical Sciences, University Hospital, Uppsala, Sweden. E-mail: ulla.lindqvist@medsci.uu.se Accepted for publication November 23, 2005.
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