Serum complement levels in patients with rheumatoid arthritis and vasculitis

It is known that serum complement levels are decreased in patients with rheumatoid arthritis associated with vasculitis, also called malignant rheumatoid arthritis (MRA). The complement profiles in patients with MRA were compared with those in uncomplicated rheumatoid arthritis (RA) and in those with systemic lupus erythematosus (SLE). In MRA patients, serum CH50, C4 and C3 levels were all decreased as in SLE patients; and C3d, an activation product of C3, and the C3d/C3 ratio as a C3 activation index were increased. Serum B level was also increased as in RA patients, but AH50 level as the haemolytic activity of the alternative pathway was within the normal range. The regulatory proteins, H and I, were elevated in sera of MRA patients. Circulating immune complexes (CIC) detected by a solid phase C1q binding method were increased, whereas the serum activity to solubilize a performed immune complex (CRA) was decreased in MRA sera. It was suggested that increased consumption of complements, mainly through the classical pathway may be responsible for the complement profiles in MRA patients: a markedly consumed classical pathway and relatively preserved alternative pathway.