Abstract
Two measurements of serum immune complexes, cryoglobulinaemia and 125I-C1q binding, have been performed in patients with severe rheumatoid arthritis (RA) and compared with normal levels. Cryoglobulinaemia was present in 20 out of 28 patients (71%) with extra-articular disease (mean level 17 micrograms/ml) including nodules, digital vasculitis, cutaneous ulcers, rash, neuropathy, lung disease and scleritis, but in none of 32 patients with joint disease alone (uncomplicated RA) (mean level 3 micrograms/ml). Cryoglobulinaemia correlates with, but probably does not antedate, extra-articular disease, and may be useful in predicting morbidity and mortailty in this group of patients. In contrast, serum 125I-Clq binding was raised in patients with uncomplicated RA and those with extra-articular disease, although levels were higher in the latter group. Both tests showed a negative correlation with serum haemolytic complement and a positive correlation with IgM rheumatoid factor although there were some sera with raised levels of rheumatoid factor without cryoglobulinaemia. These results suggest that cryoglobulinaemia is a better test than Clq-binding for demonstrating the presence of circulating immune complexes involved in the pathogenesis of extra-articular lesions.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brouet J. C., Clauvel J. P., Danon F., Klein M., Seligmann M. Biologic and clinical significance of cryoglobulins. A report of 86 cases. Am J Med. 1974 Nov;57(5):775–788. doi: 10.1016/0002-9343(74)90852-3. [DOI] [PubMed] [Google Scholar]
- CATHCART E. S., O'SULLIVAN J. B. STANDARDIZATION OF THE SHEEP CELL AGGLUTINATION TEST. THE USE OF POOLED REFERENCE SERA AND HEMAGGLUTINATION TRAYS. Arthritis Rheum. 1965 Aug;8:530–537. doi: 10.1002/art.1780080407. [DOI] [PubMed] [Google Scholar]
- CRUICKSHANK B., SINCLAIR R. J. A clinical and pathological study of sixteen cases of rheumatoid arthritis with extensive visceral involvement ('rheumatoid disease'). Q J Med. 1956 Jul;25(99):313–332. [PubMed] [Google Scholar]
- Davis J. S., Godfrey S. M., Winfield J. B. Direct evidence for circulating DNA/anti-DNA complexes in systemic lupus erythematosus. Arthritis Rheum. 1978 Jan-Feb;21(1):17–22. doi: 10.1002/art.1780210104. [DOI] [PubMed] [Google Scholar]
- Dreisin R. B., Schwarz M. I., Theofilopoulos A. N., Stanford R. E. Circulating immune complexes in the idiopathic interstitial pneumonias. N Engl J Med. 1978 Feb 16;298(7):353–357. doi: 10.1056/NEJM197802162980701. [DOI] [PubMed] [Google Scholar]
- FRANKLIN E. C., HOLMAN H. R., MULLER-EBERHARD H. J., KUNKEL H. G. An unusual protein component of high molecular weight in the serum of certain patients with rheumatoid arthritis. J Exp Med. 1957 May 1;105(5):425–438. doi: 10.1084/jem.105.5.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Franco A. E., Schur P. H. Hypocomplementemia in rheumatoid arthritis. Arthritis Rheum. 1971 Mar-Apr;14(2):231–238. doi: 10.1002/art.1780140206. [DOI] [PubMed] [Google Scholar]
- Glass D., Soter N. A., Schur P. H. Rheumatoid vasculitis. Arthritis Rheum. 1976 Sep-Oct;19(5):950–952. doi: 10.1002/art.1780190520. [DOI] [PubMed] [Google Scholar]
- Gosink B. B., Friedman P. J., Liebow A. A. Bronchiolitis obliterans. Roentgenologic-pathologic correlation. Am J Roentgenol Radium Ther Nucl Med. 1973 Apr;117(4):816–832. doi: 10.2214/ajr.117.4.816. [DOI] [PubMed] [Google Scholar]
- Jasin H. E., LoSpalluto J., Ziff M. Rheumatoid hyperviscosity syndrome. Am J Med. 1970 Oct;49(4):484–493. doi: 10.1016/s0002-9343(70)80043-2. [DOI] [PubMed] [Google Scholar]
- LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
- Mongan E. S., Cass R. M., Jacox R. F., Vaughen J. H. A study of the relation of seronegative and seropositive rheumatoid arthritis to each other and to necrotizing vasculitis. Am J Med. 1969 Jul;47(1):23–35. doi: 10.1016/0002-9343(69)90238-1. [DOI] [PubMed] [Google Scholar]
- Nydegger U. E., Zubler R. H., Gabay R., Joliat G., Karagevrekis C. H., Lambert P. H., Miescher P. A. Circulating complement breakdown products in patients with rheumatoid arthritis. Correlation between plasma C3d, circulating immune complexes, and clinical activity. J Clin Invest. 1977 May;59(5):862–868. doi: 10.1172/JCI108708. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pope R. M., Teller D. C., Mannik M. The molecular basis of self-association of antibodies to IgG (rheumatoid factors) in rheumatoid arthritis. Proc Natl Acad Sci U S A. 1974 Feb;71(2):517–521. doi: 10.1073/pnas.71.2.517. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ritchie D. M., Boyle J. A., McInnes J. M., Jasani M. K., Dalakos T. G., Grieveson P., Buchanan W. W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed] [Google Scholar]
- TOMASI T. B., Jr, FUDENBERG H. H., FINBY N. Possible relationship of rheumatoid factors and pulmonary disease. Am J Med. 1962 Aug;33:243–248. doi: 10.1016/0002-9343(62)90022-0. [DOI] [PubMed] [Google Scholar]
- Wands J. R., Mann E., Alpert E., Isselbacher K. J. The pathogenesis of arthritis associated with acute hepatitis-B surface antigen-positive hepatitis. Complement activation and characterization of circulating immune complexes. J Clin Invest. 1975 May;55(5):930–936. doi: 10.1172/JCI108022. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weinstein A., Peters K., Brown D., Bluestone R. Metabolism of the third component of complement (C3) in patients with rheumatoid arthritis. Arthritis Rheum. 1972 Jan-Feb;15(1):49–56. doi: 10.1002/art.1780150108. [DOI] [PubMed] [Google Scholar]
- Weisman M., Zvaifler N. Cryoimmunoglobulinemia in rheumatoid arthritis. Significance in serum of patients with rheumatoid vasculitis. J Clin Invest. 1975 Sep;56(3):725–739. doi: 10.1172/JCI108144. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zubler R. H., Nydegger U., Perrin L. H., Fehr K., McCormick J., Lambert P. H., Miescher P. A. Circulating and intra-articular immune complexes in patients with rheumatoid arthritis. Correlation of 125I-Clq binding activity with clinical and biological features of the disease. J Clin Invest. 1976 May;57(5):1308–1319. doi: 10.1172/JCI108399. [DOI] [PMC free article] [PubMed] [Google Scholar]