Myasthenic syndrome and oligoclonal lymphocytosis: evolution into chronic lymphocytic leukemia.
We report a patient with myasthenic syndrome who, 2 years after diagnosis, developed an oligoclonal lymphocytosis. This disorder was sustained by both kappa+ and lambda+ CD5+ B-cell clones; over the following year, the white blood cell count increased and phenotypic characterization revealed a clear imbalance in the immunoglobulin light chain ratio (84% kappa+). Accordingly, persistence of a kappa+ B-cell clone was disclosed by molecular analysis of immunoglobulin heavy chain gene rearrangements. Our results may suggest that prolonged immune system stimulation due to an autoimmune disease can drive a benign lymphoproliferation into a B-cell neoplastic process.
Radossi
P
P
Second Chair of Internal Medicine, Institute of Medical Semeiotics, University of Padua, Italy.
Dazzi
F
F
De Franchis
G
G
Vianello
F
F
Tison
T
T
Menin
C
C
Montagna
M
M
D'Andrea
E
E
D001402:B-Lymphocytes / Q000166:cytology; D015139:Blotting, Southern; D002999:Clone Cells / Q000166:cytology; D015321:Gene Rearrangement; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000209:etiology* / Q000235:genetics; D008218:Lymphocytosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D007143:Immunoglobulin Heavy Chains