1. Using crossed immunoaffinity electrophoresis with free
concanavalin A in the first dimension, we studied the
glycan microheterogeneity of
alpha 1-antichymotrypsin in sera from patients with
giant-cell arteritis and/or
polymyalgia rheumatica, and its variation in the serum of several of these patients during induction of disease remission by
prednisone therapy and possible further recurrence of
giant-cell arteritis and/or
polymyalgia rheumatica. 2. In the serum of patients with active disease we observed increased proportions of
concanavalin A nonreactive and
concanavalin A weakly reactive fractions. The results were expressed as the ratio of
concanavalin A non-reactive fraction plus
concanavalin A weakly reactive fraction to
concanavalin A reactive fraction, called R alpha 1-ACT. An R alpha 1-ACT higher than 1.8 (upper normal value) was found in 30/31 sera from patients with active disease (sensitivity 97%) and in 2/22 sera from patients with inactive disease (specificity 91%). 3. The erythrocyte sedimentation rate and the serum
C-reactive protein level, common markers of
biological inflammation, are usually elevated in active
giant-cell arteritis and/or
polymyalgia rheumatica. The two parameters are commonly used to guide the
therapy during the course of the disease, but they have no specificity. An erythrocyte sedimentation rate of greater than 30 mm/h was found in 30/31 sera from patients with active disease (sensitivity 97%) and in 5/22 sera from patients with inactive disease (specificity 77%).(ABSTRACT TRUNCATED AT 250 WORDS)