Rose Waaler Test

-JAYAN BAJRACHARYA
-B.SC.MLT 3rd year
INTRODUCTION
 ROSE WAALER test is a haemagglutination slide test for
the rapid qualitative and semi-quantitative détection of IgM
Rheumatoid Factor in sera from most patients with
rheumatoid arthritis.

It is a special type of passive haemagglutination test . In

rheumatoid arthritis , an autoantibody (RA factor) appears in
the serum, which acts an antibody to gamma globulin.

The antigen used in this test is suspension of sheep

erythrocytes sensitized with a subagglutinating dose of rabbit
anti sheep erythrocyte antibody (amboreceptor).
ADVANTAGES
I. Simple visual reading, without expert
interpretation: bi-colored latex reaction
II. Fast results for clinicians (2 minutes)
III. Cost-effective, routine laboratory test
IV. Easy and ready-to-use
V. High sensitivity and specificity
 Test principle

 When sheep red blood cells are coated with a

concentration of antiserum to sheep red blood cells
that is too low to cause agglutination, the addition of
serum from a patient with rheumatoid arthritis will
cause agglutination.
•REAG is composed of sheep red blood cells sensitized by
gamma globulins fraction of rabbit anti-sheep red blood cells
serum.

•The presence of Rheumatoid Factor in serum sample is

revealed by haemagglutination on a blue background, visible
to the naked eye.

•Otherwise, no agglutination is observed and the suspension

remains homogeneous and an uniform green-brown color.

•Handling is simple and fast. It is performed on pure serum

and he results are obtained in 2 minutes.
 TEST PROCEDURE
1. Qualitative method
 Allow the reagents and samples to reach the room
temperature. The sensitivity of test may be reduced
at low temperature.
 Gently mix the WR reagent to obtain homogenous
suspension.
 Dispense 50µl of serum upon a selected spot of
reaction slide , add one drop of WR reagent and
acurately mix with a stirrer paying attention to
uniformly distribute the liquid on the selected spot.
Rotate the slide 2 or 3 times. Leave the slide in horizontal
position for 2 mins.

After this ti me, twist the slide once to about 45° from the
horizontal and let the slide again to stay on a flat surface 1
min more, and observe the possible agglutination.

2. Semi –quantitative method

 Make serial 2 fold dilution of the sample in the saline
solution.
 Proceed for each dilution as quantitative method
TEST RESULT AND INTERPRETATION
RESULT INTERPRETATION
 + ive :  Formation of red  Presence of Rheumatoid
agglutinates on a more or less Factor
blue intense background

 - ive: No agglutination. The  Absence of Rheumatoid

suspension remains Factor
homogeneous and purple
REFERENCE
•https://www.elitechgroup.com/product/waaler-rose-bicolor /

•http://www.giessediagnostics.com/specifiche/waaler%20rose
%20slide__0.pdf
THANK YOU