Evaluation of haemagglutination tests in the diagnosis of rheumatoid arthritis. I. The S.S.C., F.II S.C., and F.II L.P. systems.

Objective Since the reports of Meyer (1922) and Waaler (1940) demonstrating that sera from patients with rheumatoid arthritis potentiated the agglutination of sensitized sheep erythrocytes, many investigators have modified the observed phenomenon in order to devise through it a test which might be diagnostic of this disease. Many modifications have been used in order to make the test more specific and less complicated. The Fourth Division Arthritis Laboratory of New York University-Bellevue Medical Centre, as part of its programme to carry out diagnostic laboratory tests on the various rheumatic diseases (Hartung and Mahood, 1955), has sought to standardize and compare these tests to make them more practical for routine use, and we have also attempted to evaluate their diagnostic accuracy. Tests Used Three haemagglutination tests for rheumatoid arthritis were performed: (1) The Heller I modification of the Rose test, formerly designated as the SEA or SCA test (Heller, Jacobson, and Kolodny, 1949) and now as the S.S.C.t test; (2) The Fraction II or gamma globulin modification of Heller, Jacobson, Kolodny, and Kammerer (1954), now referred to as the F. II S.C.t test; (3) The Latex Fixation or F.II L.P.t test (Singer and Plotz, 1956). More sensitive methods utilizing the agglutinating and inhibiting factors of the euglobulin fraction of rheumatoid serum isolated by various techniques (Svartz and Schlossmann, 1953; Ziff, Brown, Badin, and McEwen, 1954) are not at this time suitable for routine diagnostic tests because of their length and complexity.