[Characterization of cryoglobulin, M protein, low molecular weight IgM in a patient with chronic hepatitis C and type II mixed cryoglobulinemia].
The common extrahepatic manifestation of hepatitis C virus(HCV) infection is mixed cryoglobulinemia. We have analyzed serum cryoglobulin, IgM and various antibody activities from a patient with chronic hepatitis C and type II cryoglobulinemia. Cryoprecipitates were consisted of polyclonal IgG and monoclonal IgM-kappa with rheumatoid factor activity. About 20% of total IgM was found to be low molecular weight IgM by gel-filtration and SDS-PAGE. The anti-streptolysin O(ASO) activity measured by Latex agglutination method was found to be markedly elevated despite normal activity by Rantz-Randell method. The patient's serum has revealed to react against bovine gamma globulin, which crosslinked streptolysin O to Latex particles, in a nonspecific manner. Phenotypic analysis of the surface markers on abnormal lymphoid cells from peripheral blood and bone marrow showed monoclonal expansion of B-cell lineage by flow cytometry. The patient was treated with interferon-alpha, which resulted in an improvement of liver dysfunction, decreased amounts of cryoglobulin and IgM. It was concluded that the patient has suffered from lymphoproliferative disorder, namely HCV infection-associated primary macroglobulinemia.
Nishiyama
Y
Y
Central Clinical Laboratory, Kyoto University Hospital, Kyoto 606-8507.
Shimatsu
A
A
Arakawa
M
M
Nagao
M
M
Saito
A
A
Kido
A
A
Koganeya
H
H
Wada
T
T
Okuda
T
T
Ichiyama
S
S
D000368:Aged; D001426:Bacterial Proteins; D003449:Cryoglobulinemia / Q000097:blood* / Q000209:etiology; D003450:Cryoglobulins / Q000032:analysis*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood* / Q000737:chemistry; D008297:Male; D009194:Myeloma Proteins / Q000032:analysis; D013301:Streptolysins / Q000276:immunology
D001426:Bacterial Proteins; D003450:Cryoglobulins; D007075:Immunoglobulin M; D009194:Myeloma Proteins; D013301:Streptolysins; C085016:multiple myeloma M-proteins; C025964:streptolysin O