Martin J. Wohl

From the National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda 14, Maryland

Abstract Sera from 21 patients with Sjogren's syndrome with and without rheumatoid arthritis were examined. Hypergammaglobulinemia occurred in 71 per cent, the bentonite flocculation test was positive in 95 per cent and sensitized sheep cell agglutination test in 90 per cent of the entire group and in 75 per cent of patients with Sjogren's syndrome without joint involvement. Antinuclear antibody was present in 71 per cent and L.E. cells in 10 per cent. The direct Coombs' test was positive in 25 per cent and thyroglobulin antibodies were found in 14 per cent. Compared to rheumatoid arthritis patients without Sjogren's syndrome, patients in this series were distinguished by an unusually active immunologic response.

Presentation of CaseA 21-year-old woman was admitted to the hospital for cardiac catheterization.She had had multiple arthralgias most of her life. Ten years previously there was the onset of Raynaud's phenomenon, complicated by the development of ulceration and infection of the fingertips. Six years before entry she was admitted to another hospital because of arthralgias, fever, pleuritic pain and a malar rash. A diagnosis of rheumatic fever was made; she was given penicillin and prednisone and was placed on limited activity for one year. Four years before admission she began to experience progressive exertional dyspnea accompanied by occasional . . .