Antiglobulins in juvenile rheumatoid arthritis

With initial hopes of establishing a diagnostic test for juvenile rheumatoid arthritis (JRA), five types of immunoadsorbents were used to search for occult antiglobulins in sera from children. The immunoadsorbents included glutaraldehyde-aggregated globulin, heat- and glutaraldehyde-aggregated globulin, Affi-Gel-bound globulin, Sepharose-bound globulin, and bromozcetyl cellulose-bound globulin. The glutaraldehyde-aggregated immunoadsorbents retained nonspecific protein. The Affi-Gel, Sepharose, and bromoacetyl cellulose absorbents were effective and specific, but the Affi-Gel and bromoacetyl cellulose were impractical for routine use. Separose-bound globulin was selected for use in a survey of 52 patients with JRA and 8 normal children. Materials resembling occult antiglobulins, measured as acid elutable protein, were found in normal children as well as in children with JRA. Only a small proportion of children with JRA had statistically elevated levels of such occult anti-globulin consisted of IgM, IgG, and IgA, and had latex fixation activity in 2 of 5 tested sera from normal children and in 27 of 52 sera from children with JRA. Thus the presence of antiglobulins per se is not diagnostically helpful in distinguishing children with JRA.