Mixed lymphocyte reaction in healthy women with rheumatoid factor. Lack of association with HLA-Dw4.

In independent studies, 51% and 36% of patients with rheumatoid arthritis have been shown to possess HLA-Dw4 compared to 7% and 13% of controls. In one study Dw4 positive patients more frequently had rheumatoid factor in their sera than did Dw4 negative patients. In order to determine if the Dw4 specificity is associated with the disease or with the presence of rheumatoid factor, the frequency of this HLA antigen has been determined in 24 healthy women known to have rheumatoid factor (median titer 1:160). Only 3 were found to have the Dw4 specificity, suggesting that this specificity is not associated with rheumatoid factor in the absence of rheumatoid arthritis.

Concentrations of serum protein fractions in white women: effects of age, weight, smoking, tonsillectomy, and other factors;.

We measured the concentrations of protein in electrophoretic fractions (albumin and alpha1-, alpha2-, beta, and gamma-globulins) of serum from 9547 white women to determine their relations to age, weight, smoking and other factors. Albumin concentration decreases with age, beta globulin concentration increases. Increasing weight is associated with a decrease in albumin, but with increases in all the globulins. Cigarrete smoking is associated with highly significant differences in all the protein fractions. Surprisingly, very significantly lower concentrations of beta- and gamma-globulins were also found in women who reported a history of tonsillectomy. Height, amenorrhea, education, and alcohol and coffee consumption have some small but statistically significant effects upon the various fractions. Diurnal variation was also slight.

Serum protein fractions. Effects of oral contraceptives and pregnancy.

As a part of a longitudinal study to determine the side effects of oral contraceptive drugs (OCs), protein electrophoresis studies were carried out on sera obtained from 4057 current users of OCs, 9774 nonusers, and 624 women in the first trimester of pregnancy. Albumin and gamma globulin levels were lower in OC users than in nonusers; alpha-1, alpha-2, and beta fractions were higher. A similar effect was observed during the first trimester of pregnancy. The changes were temporary and reverted to normal within 12 weeks of OC withdrawal. The dosage of the estrogenic component appeared to be directly related to the lower concentration of albumin in users. The mechanisms of these changes were not well identified but very likely represent a direct effect on the metabolism of proteins.

Rheumatoid factor (antigammaglobulin) in women: effects of oral contraceptives use of its prevalence.

A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease.

PIP: To determine the influence of oral contraceptives (OCs) on the prevalence of the rheumatoid factor, 14,856 18-45 year old women were studied. Of these, 921 were pregnant and 4562 were currently using OCs. 5118 were past users of OCs. The prevalence of rheumatoid factor was directly related to age (p less than .001), being higher in older women. The age-adjusted prevalence of rheumatoid factor among current users of OCs was 25% lower than among others. Among nonusers and former users there was equal prevalence. Among the 921 pregnant women, 9 (1%) were found to have positive tests for rheumatoid factor. Among OC users the rate of positive tests was 1%, but the rate was only .8% among nonusers in the 18-29 age group. Repeat rheumatoid factor studies were done on 7427 women after an average 16-month interval. 882 had discontinued OC use and 481 resumed or started OCs during the interval between tests. Those who had continued, started, or resumed OC use showed a reduction in positive tests while positive tests were increased among those who discontinued OC use. Among the 7427 women, 122 were positive for rheumatoid factor on their 1st test but only 46 (39%) remained positive. 16 women changed from negative to positive. Rheumatic disorders were present in 5.4% of all persons who had positive tests. Only 1 current user was thought to have rheumatic arthritis. Those with high titers of rheumatoid factor remained positive in 81% of cases. Findings indicate that OC use does not induce the formation of the rhematoid factor.

Progressive multifocal leukoencephalopathy: a complication of immunosuppressive treatment.

Progressive multifocal leukoencephalopathy developed in a patient with rheumatoid arthritis after treatment with an immunosuppressive agent (chlorambucil). We fell that this case lends further support to the concept that an altered immunologic state is important in the appearance of this infection, which is probably viral in origin.