Alloimmunization to human immunoglobulin genetic markers is frequent in early rheumatoid arthritis.

: HLA and Gm allotypes of 99 consecutive Swedish patients with rheumatoid arthritis were determined. Ninety-two of the 198 haplotypes contained DR4, a significant increase. The patients' sera from 3 different occasions were studied for anti-immunoglobulin profile as judged by 6 selected anti-Rh coats, 4 of them being monoclonal anti-Ds restricted as to allotype. Ninety-two of the patients were reactive with a polyclonal anti-Rh Ri as against 10 with the monoclonal carrying the G1m(f) allotype. Antibodies to Ig coats carrying defined allotypes were more frequently observed in patients not carrying the allotype in question than in those individuals possessing it. The difference was significant or highly significant as regards presence/absence of G1m(a), G3m(b) and G3m(g), respectively. Anti-G1m(a) and anti-G3m(g) cooccurred in 17 of the patients. Results consistent with presence/absence of particular anti-immunoglobulins at the 3 examinations were observed in 74 of the patients. Gm allotypes or antiallotypes were not statistically related with DR4 status. In conclusion, alloimmunization to Gm markers frequently occurs in early rheumatoid arthritis.