SONDERSTELLUNG DER SERONEGATIVEN CHRONISCHEN POLYARTHRITIS? KLINISCHES, BIOCHEMISCHES UND IMMUNGENETISCHES PROFIL DER FRUHEN SERONEGATIVEN UND SEROPOSITIVEN CHRONISCHEN POLYARTHRITIS

In the framework of an early-diagnosis out-patients clinic 100 patients (mean age 51 years), 82 of them female, were identified as highly suspicious of having chronic rheumatoid arthritis of recent onset (2-12 months). Five or more ARA criteria were present in 77 patients. IgM rheumatic factor was present in serum of 51 patients (latex fixation test). A Waaler-Rose test of ≥ 32 IU/ml was present in 21. After adjusting for α errors, there was a significantly higher prevalence of HLA-DR4 among those seropositive in the latex fixation test (64 vs 29%). A further 19 constitutional, anamnestic, clinical, biochemical and psychosocial criteria failed to reveal any different distribution between seropositive and seronegative cases. Using the specific definition of seropositivity in the Waaler-Rose test eliminated HLA-DR4 differences. The latter did not serve as a distinguishing criterion. There was only a marginal difference between DR4-positive and negative patients. These results fail to lend support to recent views of a special position of seronegative chronic rheumatoid arthritis.