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Rheumatoid factor (RF) testing by latex fixation in 8,287 outpatients yielded a sensitivity of 81.6% and 78.0% at titers of 1:20 and 1:80, respectively, and a specificity against noninflammatory rheumatic disorders (NIRD) of 96.6% and 97.9% and against NIRD plus inflammatory disorders of 95.2% and 96.8%, respectively. The predictive value of a positive test result at the clinic prevalence rate for rheumatoid arthritis (RA) (16.4%) was approximately 80%, and was 70% at 10% prevalence and 10% at 1% prevalence. No associations of RF with age or sex were found in non-RA patients. RF titers increased minimally with age in RA patients and were higher in men than in women. This study suggests that latex testing is far more specific than has been believed and that the titer is not spuriously increased with age.
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The usefulness of Serodia-Myco II agglutination test (Fujirebio, Japan) for diagnosis of the M. pneumoniae infections was evaluated. A total of 66 serum samples obtained from patients with respiratory tract infections were tested by Serodia-Myco II test, complement fixation (CF) test, ELISA-IgG/-IgM, and by latex agglutination (LA) test prepared in our laboratory. Using CF test and ELISA as the reference tests, Serodia-Myco II test gave too many false positive results. This test in relation to CF test, ELISA-IgM, ELISA-IgG, and LA test showed a very high sensitivity, virtually 100%, with a low specificity, below 50%. It seems that oversensitivity of the Serodia-Myco II test is caused by too low cut off (40) value recommended by the manufacturer. The Serodia-Myco II test may be used in routine serodiagnosis of mycoplasmosis under condition that cut off value will be raised to 160 and the positive results of this test will be confirmed by the CF test or ELISA.
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TORCH tests can be used to document immunity or recent infections. Many laboratories now offer TORCH tests and there are a large variety of methods, kits, and reporting systems. Some of the TORCH tests are not accurate and should be avoided. In general, we prefer enzyme immunoassays for documentation of past infections or immunity. To demonstrate recent infections with toxoplasmosis and rubella we use IgM enzyme-linked immunosorbent assay tests but for cytomegalovirus and herpes infections we prefer virus isolation. Physicians should send specimens only to laboratories that participate in proficiency surveys or similar tests that document the accuracy of the laboratory. All TORCH test sera should be held by the laboratory for 1 year to permit repeat testing and analysis with subsequent specimens if necessary.
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1. Rheumatoid factors were found in 12 of a total of 105 SLE patients. 2. Rheumatoid factors were found especially in patients with additional chronic polyarthritis, whereas it was not possible to find a relation between these factors and the age of patients and the duration of disease, respectively. 3. There was no difference between SLE and progressive polyarthritis as regrads the cold precipitation of rheumatoid factors. 4. In vitro fixation of the complement to antinuclear factors was not hindered by rheumatoid factors. 5. Renal lesions and uremia were observed in SLE patients with and without rheumatoid factors, the percentages being roughly the same in the two groups.