Rhematiod factor is an autoantibody, usually of the IgM class directed against human IgG. It is found in the serum of patients with joint and connective tissue disease, as well as in some chronic infective states. Rheumatoid arthritis is associated with HLA DR4. RA is associated with a Coomb’s-positive haemolysis. Myelo- and lymphoproliferative disorders and neoplastic disease are associated with increased purine turnover and affected individuals are more prone to gout. Peking cells are neutrophils containing macrophages. X-rays may reveal periostitis at ligament insertions and rheumatoid-like changes. Raynaud’s disease may be a feature of connective tissue disease, especially scleroderma, SLE, and rhematoid arthritis. Sjogren’s syndrome is ninefold commoner in women. It is a disease characterized by inflammation and destruction of exocrine glands including: lacrimal, salivary, sweat glands, and mucous glands of the bowel, vagina, and bronchial tree, causing constipation and dyspareunia.