Comparison of Differential Agglutination Titre (D.A.T.) in Juvenile and Adult Rheumatoid Arthritis.

In the preceding paper (Bywaters, Carter, and Scott, 1959), it was shown that the Rose-Waaler test (positive in about 50 to 70 per cent. of adult rheumatoid arthritis cases) is frequently negative in childhood arthritis (Still's disease). This has also been remarked by others (Pike, Sulkin, and Coggeshall, 1955; Alexander and de Forest, 1954; Ziff, 1957), although by the inhibition technique 95-8 per cent. are positive (McEwen, Ziff, Carmel, Di Tata, and Tanner, 1958). This raises the possibility that Still's disease is different from the rheumatoid arthritis seen typically in adults, as Still (1897) originally postulated. To provide further data pertinent to this, we have estimated the Rose-Waaler titre over a period of several years in a series of over 200 children and this report compares the titre in 142 juvenile cases followed for a minimum of 4 years with an adult group of rheumatoid arthritis patients. All sera were tested by one of us (F.E.T.S.) by the method described in the previous paper (Bywaters and others, 1959).