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Complement-fixing (CF) antibrain antibodies are frequently found in serum and CSF in multiple sclerosis (MS). A negative result in the test for these antibodies might depend not only on a lack of antibodies, but also on serologic inhibiting factors. To test this possibility, serum and concentrated CSF samples without demonstrable CF antibrain antibodies were allowed to interact with two standardized positive complement fixation reactions; one for antibrain antibodies and the other a Wasserman reaction. No evidence of inhibiting activity was found in 11 CSF and 15 serum samples from 20 MS patients. On the other hand, inhibiting activity was seen in serum from four of 12 patients with neoplasms and from three of 11 patients with rheumatoid arthritis.
A single radial haemolysis (SRH) technique, using Reiter protein or Reiter lysate as the coating antigen, was investigated. Results obtained with syphilitic and presumed non-syphilitic human sera were compared with results obtained in the absorbed fluorescent treponemal antibody test (FTA-ABS), the Reiter protein complement fixation test ( RPCFT ), the Venereal Diseases Research Laboratory Slide test (VDRL) and the Cardiolipin Wasserman reaction ( CWR ). The SRH reaction, with either Reiter antigen, was more sensitive than any of the screening tests ( RPCFT , VDRL and CWR ) for detecting positive syphilitic antibodies. Although the SRH test used almost the same materials as the RPCFT , it was appreciably more sensitive for the detection of the group-specific antibodies in syphilitic human serum.
The objective was to identify cases of incomplete systemic lupus erythematosus (SLE) within a defined population in southern Sweden, risk factors for development of complete SLE (> or = 4 classification criteria) and study outcome of the patients. During prospective retrieval of SLE cases within a defined population in southern Sweden, 28 patients (26 women, two men) with incomplete SLE (< 4 ACR criteria) were identified between 1981 and 1992. All patient records were reviewed and clinical and laboratory data were extracted from standardized formats. Organ damage was defined according to the SLICC/ACR damage index. During follow-ups, 16 of 28 patients developed complete SLE (median 13 years; range 10-20 years). The time to develop complete SLE varied between one and ten years with a median time of 5.3 years. Three patients were anti-DNA positive at inclusion; only one of them developed complete SLE. False positive Wasserman reaction and anti-cardiolipin antibodies (aCl) were only found in patients who developed complete SLE (P < 0.04; Fisher exact test). Six patients had malar rash from the start and they all had complete SLE at follow-up (P < 0.04; Fisher exact test). Of eight patients with arthritis, three developed complete SLE. Thrombocytopenia was only found in two patients, both developing complete disease. At follow-up, patients that developed complete SLE had high SLICC damage scores (mean 1.5) compared with patients that remained as incomplete SLE (mean 0.16). In conclusion, in this follow-up study of patients with incomplete SLE 57% developed complete disease after a median time of 5.3 years. Malar rash and aCl were predictors of complete SLE. Individuals that developed complete SLE were more prone to organ damage.
An IgM lambda M-component with a false Wasserman reaction and 'false' rheumatoid factor activity from a patient suffering from a well-differentiated lymphocytic lymphoma is presented. The monoclonal protein showed antibody activity against cardiolipin and cross-reacted with acryl particles, not with human IgG. Both these activities were found in the Fab fragment. The reduction of the 19S IgM to 7S IgM subunits was responsible for a strong decrease in activity. The importance of the IgM quaternary structure in determining antibody affinity is emphasized.
Clinical variants of laryngeal lesions in patients with early syphilis are reviewed. A case of secondary syphilis with a laryngeal lesion is reported in a female who developed aphonia. Basing on laryngoscopic findings, an otorhinolaryngologist made the diagnosis "chronic laryngitis, singer's nodules". The authors infer that painless laryngitis of long duration without signs of inflammation and resistant to standard treatment should be tested for syphilitic etiology. Therefore, the patient's blood should be taken for Wasserman reaction while the patient should be consulted by venereologist.
It has been suggested by several authors that so called 'primary' pulmonary hypertension may have an 'autoimmune' basis because of the clinical association of this condition with Raynaud's phenomenon, polyarthritis and its not infrequent association with other conditions affecting connective tissue, such as progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE), often in the absence of pulmonary parenchymal disease. In addition, serum protein abnormalities, positive antinuclear factors and the occasional positive rheumatoid flocculation tests or false/positive Wasserman reaction have also been noted. Data are presented on 9 patients with this condition, in whom not only was there a high frequency of antinuclear factor present (ANA) but in addition, a higher than average incidence of antibodies to smooth muscle (SMA). Screening for antibodies to DNA, extractable nuclear antigens, anticentromere antibodies and antibodies to cardiolipin were uniformly negative. The significance of these negative results are briefly discussed.