The association of cryoglobulinaemia with nodules, vasculitis and fibrosing alveolitis in rheumatoid arthritis and their relationship to serum C1q binding activity and rheumatoid factor

Clin Exp Immunol. 1979 Dec;38(3):405-13.

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.

MeSH terms

  • Antigen-Antibody Complex
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / immunology*
  • Blood Protein Disorders / immunology*
  • Complement C1 / metabolism*
  • Cryoglobulins / analysis*
  • Humans
  • Immunoglobulins / metabolism
  • Pulmonary Fibrosis / complications
  • Rheumatoid Factor / metabolism*
  • Rheumatoid Nodule / complications
  • Vasculitis / complications

Substances

  • Antigen-Antibody Complex
  • Complement C1
  • Cryoglobulins
  • Immunoglobulins
  • Rheumatoid Factor