title: Myasthenic syndrome and oligoclonal lymphocytosis: evolution into chronic lymphocytic leukemia.
abstract: 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.
authors.affiliation: Second Chair of Internal Medicine, Institute of Medical Semeiotics, University of Padua, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Radossi
authors.forename: F
authors.initials: F
authors.lastname: Dazzi
authors.forename: G
authors.initials: G
authors.lastname: De Franchis
authors.forename: F
authors.initials: F
authors.lastname: Vianello
authors.forename: T
authors.initials: T
authors.lastname: Tison
authors.forename: C
authors.initials: C
authors.lastname: Menin
authors.forename: M
authors.initials: M
authors.lastname: Montagna
authors.forename: E
authors.initials: E
authors.lastname: D'Andrea
mesh_terms: 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
chemical_list: D007143:Immunoglobulin Heavy Chains