A monoclonal IgM rheumatoid factor ( R Q from a patient with mixed essential cryoglobulinaemia was found to bind to type M15 group A streptococci with high affinity. The reaction was exerted via the antibody combining sites since it was inhibited by F(ab'>;? fragments of anti-idiotypic (Id) antibodies but not by F(ab')2 of anti-IgMFc or normal rabbit IgG. The streptococcal strain also possessed receptors for the Fc part of IgG. IgMRF and IgG attached to different sites on the streptococcal surface, since e.g. anti-Id did not inhibit the IgG Fc-receptor binding. Furthermore, it was found that the interaction between the streptococcal IgG Fc receptor and IgGlike the RF/IgG interactiontook place in the interface between Cy2 and Cy3 and that histidine 435, tyrosine 436 and/orone or both of histidine 433 and 310 were involved.This study was supported by grants from "Riksforbundet mot Reumatism," the Alfred Osterlund Foundation and the Swedish Medical Research Council. Scand J Rheumatol Downloaded from informahealthcare.com by University of Otago on 12/26/14 For personal use only. Scand J Rheumatol Downloaded from informahealthcare.com by University of Otago on 12/26/14 For personal use only.