Autoimmunity in thermal injury: occurrence of rheumatoid factors, antinuclear antibodies and antiepithelial antibodies.

Immunologic changes in patients and experimental animals with skin burns include impairment of delayed hypersensitivity and the presence of autoantibodies. We have studied thirty-one patients with burns (2–46% area, 12–82 years old) to determine the incidence of autoantibodies, to evaluate their clinical significance and to explore the burn syndrome as a model of autoimmunity. By indirect immunofluorescence, sixteen sera (52%) showed antiepithelial (`pemphigus-like') antibody and seven gave basement layer staining. The antibody did not fix complement . Eleven (35%) had antinuclear antibodies reactive with rat liver nuclei. Tests for antiDNA and deoxyribonucleoprotein were negative. Twenty patients had positive latex fixation tests (LFT) (67%) with titres above 1:80 in eight. Eight of twenty-eight (32%) had a positive sheep cell agglutination test (SCAT). Patients over 59 years tended to be more reactive in tests for rheumatoid factor (RF) than the younger group. The incidence of positive LFT and SCAT was significantly higher than controls. There was no clear relationship of the presence of one antibody to the other nor to the severity and final outcome of the injury.