No abstract

The possibility that a disordered immune response is related to the development of the rheumatic diseases has been an attractive hypothesis for investigation for years. Several investigators have attempted to demonstrate quantitative differences in the immune response between patients with these diseases and control subjects when they were inoculated with various antigens. Rantz, Creger and Choy (1) challenged patients with rheumatic fever and rheumatoid arthritis by injecting isologous red blood cells intravenously, and by the inoculation of influenza A and B vaccine. The patients with rheumatic fever responded with an increased titer of isohemagglutinins and in increased titer of antibodies to influenza virus compared with the control groups. There was no difference in the immune response to these two antigens between the rheumatoid arthritic patients and control subjects. In a prospective study, Rejholec (2) administered brucella vaccine subcutaneously to a group of 900 children. A small group developed very high titers of brucella antibody, measured by the indirect Coombs technique. All the children were followed clinically and a very high percentage of the hyper-reactors were shown subsequently to develop rheumatic fever; indeed, the only cases of rheumatic fever appeared in this hyper-reactor group. Miller, Kibrick, and Massel (3), by using influenza virus and typhoid. 0 and H antigens, were unable to show hyperreactivity in a group of patients with rheumatic *

YSTEMIC LUPUS ERYTHEMATOSUS (S.L.E.) is