A case of Waldenstroem's disease with a monoclonal IgM antiphospholipid antibody.
The antiphospholipid syndrome (APS) was described in 1983 as a clinical entity characterized by venous and arterial thrombosis, thrombocytopenia, and recurrent fetal loss. The serological markers of APS are antiphospholipid antibodies (APLA) directed mainly against anionic phospholipids, usually cardiolipin but also phosphatidylserine. Some APLA exhibit lupus anticoagulant activity. Monoclonal gammopathy sometimes occurs with the presence of autoantibodies. In this paper, we describe a patient with the diagnosis of immunocytoma with an IgM, kappa paraprotein with apparent specificity against anionic phospholipids, and lupus anticoagulant activity, but no clinical signs of APS. We describe in this patient the presence of a high titer of monoclonal APLA, which does apparently not induce the clinical symptoms of APS. This might be indicative for the presence of pathogenic and nonpathogenic antiphospholipid antibodies.
Department of Internal Medicine I, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany. philipp.landenberg@klinik.uni-regensburg.de
Philipp
P
von Landenberg
Jürgen
J
Schölmerich
Reinhard
R
Andreesen
Martin
M
Vogelhuber
Karl J
KJ
Lackner
D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D005260:Female; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007145:Immunoglobulin kappa-Chains / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008875:Middle Aged; D010266:Paraproteins / Q000378:metabolism; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000097:blood / Q000276:immunology*; D053482:beta 2-Glycoprotein I
D017152:Antibodies, Antiphospholipid; D006023:Glycoproteins; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D016682:Lupus Coagulation Inhibitor; D010266:Paraproteins; D053482:beta 2-Glycoprotein I