Dysglobulinemias revealing rheumatoid arthritis

Fifteen patients (with dysglobulinemia, ranging in age from 35 to 52 years, were studied over a period of 6 years. The following parameters of immune response and immunoelectrophoresis of serum proteins were checked: total hemolytic complement (CH50), serum cryoglobulins, presence of circulating immune complexes (CIC), beta 2-microglobulins, rheumatoid factor (RF). Of the 15 patients investigated, 6 (40%) developed during the period of study severe forms of rheumatoid arthritis (RA) which required the introduction of continuous cortisone therapy. In a control group, ranging between the same age limits but without immune disturbances, no case of RA was observed. It should be noted that polyclonal hypergammaglobulinemia preceded by at least 5 years the appearance of articular inflammation. The changes of serum complement were also significant. CH50 was found constantly decreased below 40 HU/ml, particularly in the patients with febrile forms of RA; positive latex fixation test greater than 1/80 was observed at least 6 months before the appearance of articular tumefactions. Increase of beta 2-microglobulins in the serum and the presence of cryoglobulins was also observed in the 4 patients with RA. Dysglobulinemia has often been observed in the course of RA but it has seldom been presented as a preceding disturbance predicting the disease. The originality of the observations reported in this paper consists in a case of malignant RA appeared in the course of dysglobulinemia.