Syndrome Associated with Chronic Lymphatic Leukaemia

These results are similar to those obtained by Schluederberg (1965), who found consistent twofold to fourfold reductions in antibody titre after treatment with 2ME in serum obtained at 12-day to 21-day intervals after measles vaccination and natural infection with mumps virus, but no reduction in those obtained two months or more after infection. Lindquist et al. (1965), employing neutralization tests, observed fourfold or greater reductions in rubella antibody titre in seven of nine infants aged 10 weeks or less with the rubella syndrome, suggesting that, in addition to maternal IgG immunoglobulins, infants were synthesizing their own antibody, consisting principally of IgM components either before birth or in the neonatal period. Although treatment with 2ME provides a considerably less precise estimate of the presence of IgM immunoglobulins than, for example, analyses of antibody components by means of sucrose density gradients or gel filtration on Sephadex, the technique is simpler and can be used more readily if many sera have to be tested routinely. Even though the action of 2ME may not be entirely selective in breaking down only IgM immunoglobulins, both this and Schluederberg's series (1965) demonstrate that reduction in antibody titre after virus infection in early but not late convalescent sera, even though sometimes of small magnitude, is consistent. Reductions in antibody titre after treatment with 2ME compared favourably with complement-fixing tests as an index of recent infection by rubella virus. However, treatment with 2ME may be especially useful in assessing the duration of antibody in single serum samples obtained in the early stages of illness, a period at which greatest reductions in antibody titres are to be expected, or in obtaining evidence of recent infection in a proportion of patients who might present in early convalescence before complementfixing antibody has fully developed. These preliminary results suggest that this test, since it can be both simply and rapidly performed, may, in conjunction with virus isolation and other serological tests, be of additional value in the assessment of patients who have been contacts of or who gave a history of rubella during pregnancy.