Abstract: 1437
November 11, 1998
Poster Session E: RA Clinical Aspects: Etiopathogenesis and Genetics
8:00-9:30 am, Hall B1/C
BREAKDOWN OF THE VAGINAL ECOSYSTEM IN PATIENTS WITH RHEUMATOID ARTHRITIS
Seung Cheol Shim, Tae-Hwan Kim, Jae-Bum Jun, Sung Soo Jung, In
Hong Lee, Sang Cheol Bae, Jung Hye Hwang1, Young Jin Moon1, Soo
Hyun Cho1, Tae Yeal Choi2, Dae Hyun Yoo, Seong Yoon Kim
The Hospital for Rheumatic Diseases, Department of Internal Medicine;
1Department of Gynecology; 2Department of Clinical Pathology, Hanyang
University College of Medicine, Seoul 133-792, Korea
Introduction: Infectious etiology has been continuously discussed in
rheumatoid arthritis (RA), and many bacteria and virus have been
considered. Normal vaginal flora is dominated by lactobacilli which
decrease the vaginal pH through production of acidic products so that
infectious disease by other pathogenic organisms could be prevented.
Also, vaginal pH generally becomes more acidic in pregnancy.
In the respect of common mucosal immunity, primed lymphocytes are
circulating into intestinal lymphoid organ, genitourinary organ and
joints.
Aims: To evaluate the vaginal environment of the patients with RA.
Methods: Vaginal specimens were obtained from 80 patients with RA and 80
control subjects. We examined the vaginal pH, clue cell and conducted
amine test, Gram stain, and vaginal culture. We interpreted the results
of Gram stain with scoring system for vaginal smear by Nugent.
Results: In postmenopausal group, the average vaginal pH was higher in
RA (6.56) than in control group (5.76, p = 0.051). The average of Gram
stain score was also higher in RA (4.65) compared with control group
(1.23, p < 0.01). The same results were shown in premenopausal groups
(vaginal pH, 6.02 and 4.51, p < 0.01, and Gram stain score, 4.50 and
0.72, p < 0.001, respectively).
There was insignificant correlation between the dose of steroid and
vaginal pH (r = 0.19, p = 0.37) or Gram stain score (r = 0.15, p =
0.539).
Conclusion: These results showed that the balance of the vaginal
ecosystem was broken in the patients with RA, and it might be one of the
etiologic factors or the aggravating factors in RA.
Disclosure: work reported in this abstract was supported by:
Hanyang University.