Hyperglobulinaemia in rheumatoid arthritis; its relationship with disease activity and its changes under adrenocortical treatment.

Hyperglobulinaemia is a fundamental characteristic of rheumatoid arthritis, and is also found in other collagen diseases. It is said to demonstrate the hyperactivity of the reticulo-endothelial system shown by the hyperplasia of its medullary elements (Marmont, 1948; Curletto and Magistretti, 1949). In the course of studying this hyperglobulinaemia by paper electrophoresis, an increase has been observed in the alpha and gamma globulin fractions (Olhagen, 1952; Wallis, 1950; Ropes, Perlmann, Kaufman, and Bauer, 1954; Jacqueline, de Traverse, and Besson, 1954; Hunt and Trew, 1954), or in the beta-gamma globulin fractions (Layani, Bengui, and de Mende, 1952). An increase in the alpha-2 globulin is considered to be characteristic of the first phase of rheumatoid disease, associated with inflammatory-exudative changes; an increase in gamma globulin generally appears later, together with a reactionary fibrosis (Olhagen, 1952; Ropes and others, 1954; Layani and others, 1952; Jacqueline and others, 1954). In exceptionally serious cases, a conspicuous increase in the gamma globulin fraction and a moderate increase in the alpha globulin fraction (Olhagen, 1952), or a persistently raised gamma-l globulin (Layani and others, 1952), have been observed. During the hormone therapy of rheumatoid arthritis, a decrease has been noted in the alpha globulins (particularly alpha-2), and especially in the gamma globulins in cases which were progressing favourably (Wallis, 1950; Villa, Ballabio, and Sala, 1953; Layani and others, 1952; Ropes and others, 1954). After an initial decrease in the medullary reticulo-endothelial hyperplasia, the electrophoretic pattern and the sero-agglutinating titres returned to normal (Berglund, Nordenson, and Glhagen, 1951). Similar electrophoretic changes