Fourteen patients with antinuclear activity demonstrable in their serum were studied in detail. All had severe, deforming rheumatoid arthritis with visceral manifestations, and eight had chronic leg ulcers. Serum protein chromatography provided evidence that, in these patients, macromolecular globulins comprised a greater proportion of the antinuclear activity than was true in systemic lupus erythematosus. The factors were considered to be a manifestation of rheumatoid arthritis possibly provoked by chronic bacterial infection.Dece-quatro patientes con activitate antinucleari demonstrabile in le sero esseva studiate in detalio. Omnes habeva sever grados de deformante arthritis rheumatoide con manifestationes visceral, e octo habeva chronic ulceres de gamba. Chromatographia del proteinas del sero provideva evidentia que in iste patientes le globulinas macronucleari comprendeva un plus grande proportion del activitate antinucleari que in patientes con systemic lupus erythematose. Esseva opinate que le factores esseva un manifestation de arthritis rheumatoide, provocate possibilemente per chronic infection bacterial.
HE PATIENT with rheumatoid arthritis whose serum is found to pro-
T duce L.E. cells defies classification as either rheumatoid arthritis or systemic lupus erythematosus. The American Rheumatism Association criteria for the diagnosis of rheumatoid arthritis (R.A.) exclude those patients with a significantly positive L.E. cell preparati0n.l This exclusion has been interpreted to support the opposite view that the appropriate diagnosis is systemic lupus erythematosus ( S.L.E.
