Intra-articular dissociation of the rheumatoid factor.

Abstract

Abstract It has been shown that the macroglobulins of Waldenstrom's macroglobulinemia and cold agglutinin hemolytic anemia can be dissociated in vivo by the administration of penicillamine. The rheumatoid factor is a macroglobulin. The results of in vitro dissociation of the rheumatoid factor by sulfhydryl compounds are presented. While penicillamine was effective in achieving in vitro dissociation, oral administration of this thiol to rheumatoid patients for 14 days failed to produce in vivo dissociation. When sulfhydryl compounds were introduced directly into the joint space, however, dissociation of the rheumatoid macroglobulin was consistently produced. Immunologic reactivity was lost and the latex test became negative for short periods. The feasibility of in vivo dissociation of the rheumatoid factor has thus been established and lends encouragement to the possibility that this substance may be reduced in the serum with more potent sulfhydryl compounds.