April 1963

The Immunology of Rheumatism

Author Affiliations

By J. B. Kwapinski and M. L. Snyder. Price, $9. Pp. 255. Appleton-Century-Crofts, 35 W 32nd St, New York 1, 1962.

Arch Intern Med. 1963;111(4):535. doi:10.1001/archinte.1963.03620280135038

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Knowledge concerning altered protein factors found in the serum of patients with rheumatic diseases has been accumulating at such a rate that a comprehensive review of this subject would be valuable. The authors of this book have attempted such a synthesis based upon extensive personal experience in testing sera and upon an exhaustic review of the literature. The result is an enumeration of much detail, but, unfortunately, the data presented do not support their conclusions.

The authors' hypothesis is that various rheumatic diseases, particularly rheumatic fever and the "collagen" diseases, have a common etiology; that initially the process is marked by elevated antistreptococcal antibodies; and that in time these decline and are replaced by elevated titers of "rheumatic heteroreagens." Under this latter term the authors group the serum rheumatoid and antinuclear factors, C-reactive protein, and a variety of tests reflecting changes in γ-globulins and mucoproteins. These "heteroreagens," the authors state,

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