[The latex fixation test in the diagnosis of rheumatic and other diseases selected for comparison].
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Routine laboratory tests (Rose-Waaler test, latex fixation test) for the detection of rheumatoid factor (RF) measure IgM RF by its ability to agglutinate sheep red blood cells or latex particles coated with IgG. Recently, solid-phase RIA and ELISA have been developed to detect RF of all major immunoglobulin classes in a sensitive and reproducible manner. In the literature the pathogenetic, diagnostic and prognostic significance of IgA, IgG and IgM RF is discussed. Using a micro-ELISA with human IgG-Fc-fragments as antigens, we have detected IgA RF and/or IgG RF not only in sera from seropositive rheumatoid arthritis (RA) (n = 48), but also in 13 of 22 sera from seronegative RA, which was statistically significant compared with a group of 50 normal controls. There was a good correlation between IgM RF in ELISA and Rose-Waaler titres for agglutinating RF (r = 0.70). No RF were found in patients with psoriatic arthritis (n = 16).
Comparison of a tube latex agglutination (LA) test and a microtitration complement-fixation (CF) test for the diagnosis of Mycoplasma hyopneumoniae swine pneumonia was done. In a group of 107 pigs from Iowa, Texas, and California (survey A), correlation of data on microscopic pulmonary changes with the LA and CF titers indicated the LA test might be a better indicator of microscopic lesions than the CF test. In another field study involving lungs from 50 pigs from various herds (survey B), both LA and CF test results predicted gross lesions at a 0.01 significance level, using chi-square analysis. Data from 3 Nebraska swine herds (survey C) indicated good correlation of gross and microscopic pulmonic lesions with CF and LA test results in 2 of the 3 herds. In the 3rd herd, results of the CF test failed to agree with either gross and microscopic pulmonic lesions or culture results, whereas LA test results closely correlated with these variables. Chi-square analysis at 0.5 significance level of 106 pigs from 5 Iowa specific-pathogen-free herds (survey D) indicated a correlation of CF and LA test results with the microscopic pulmonic changes of penmates.
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About 1% of the Dutch population is per year checked for the first time for the presence of rheumatoid factors (RF). Unfortunately, the interlaboratory variations of the titres of RF tests are enormous. We therefore (re)studied the effect of comparisons of the results with the WHO standard rheumatoid serum, leading to expression of the results in international units (IU), instead of in titres. Testing 5 sera in duplicate in 33 laboratories, a significant decrease of the interlaboratory variability was noted for the Waaler-Rose test, the Latex fixation test and the ELISA for the demonstration of RF's. Also the results of the antiperinuclear factor (APF) test improved significantly. The results of RF's demonstrated with the indirect immunofluorescence technique showed already a satisfactory comparability. Expression in IU's had no significant effect for this test. The introduction of the use of a reference serum met no opposition. Nearly all Dutch laboratories express now their results in units.
Renal biopsies and sera from 41 consecutive patients were studied to determine if antiglobulins were found more frequently in patients with severely diseased glomeruli. Patients were classified into three groups: A, 12 patients with normal renal function and minimal histological evidence of glomerular disease; B, 18 patients with normal renal function but distinctly abnormal biopsies (16 cases) or proteinuria greater than 16 g/24 h (2 cases); and C, 11 patients with both decreased function and abnormal histology. Positive latex fixation tests for rheumatoid factor were found in none of group A, four (22%) of group B, and five (45%) of group C patients. Sera heated 56 degrees C for 30 min contained precipitins reactive with heat-aggregated IgG in none of seven group A, five of ten (50%) group B, and four of ten (40%) group C patients. The quantity of 135I-labeled patient globulin which bound to immunoadsorbents coated with Cohn fraction II in competition with an equal quantity of 131I-labeled globulin from pooled plasma of normal donors was also measured. Patient globulins bound in significantly greater quantity (greater than or equal 2 SD) than the control in none of the group A, 7 of 18 (39%) group B, and 7 of 11 (64%) group C patients. Renal biopsies from 18 patients were also studied for the ability to fix fluorescein-conjugated heat-aggregated and native human IgG. None of nine tissue specimens from group A or B patients fixed either fluorescein-conjugated protein whereas tissue from eight of nine group C patients showed glomerular localization of one or both reagents. Severity of disease as judged by renal function and glomerular histology correlated with the presence of tissue-fixed and serum antiglobulins. Thus, detection of antiglobulins in glomeruli and sera of patients with glomerulonephritis may indicate a relatively poor prognosis and raises the possibility that antiglobulins may be implicated in some way in the pathophysiology of human glomerulonephritis.