title: [Characterization of unusual macro CK1 of IgG3kappa-cK-MM type detected in the serum of a patient with idiopathic thrombocytopenic purpura].
abstract: An unusual creatine kinase (CK) band detected in the serum of a patient with idiopathic thrombocytopenic purpura (ITP) was studied. The number of platelets of the patient decreased to 2.3 x 10(4)/microL, and serum CK and CK-MB activities increased to 899 and 62.7 U/L, respectively. The unusual CK band with a molecular size of 320,000 migrated to the cathodal side of CK-MM through electrophoresis, and the position was similar to that of octameric mitochondrial CK(Mi-CK). However, the cathodal band did not react with anti ubiquitous or anti-sarcomeric Mi-CK antibodies; instead, a reaction of the band occurred with anti-CK-M subunit antibodies and CK activity was inhibited. In addition to the cathodal band of CK-MM, an atypical CK band was simultaneously detected on the anodal side of CK-MM. It was found that the cathodal and anodal bands were macro CK1 of IgG3kappa-CK-MM and IgG1kappa-CK-MM, respectively, by immunofixation electrophoresis with anti-IgG subclass antibodies. The number of platelets began to increase one week after the elimination of Helicobacter pylori. The cathodal band activity showed an opposite migration one to two weeks following the platelet count change. Change of the anodal band began one month or longer following the platelet count change. One year following the first medical examination, the level of IgG3 in the serum of the patient decreased to 45%, and the percentage was lower than those of the other IgG subclasses. These results suggest that changes in the cathodal band are associated with those of the number of platelets and reflect the disease state of the patient. In conclusion, the cathodal band of CK-MM in the serum of an ITP affected patient was macro CK1 of IgG3kappa-CK-MM type, it migrated to the opposite sides of the platelet count change, and reflected the disease state of the patient.
authors.affiliation: Department of Clinical Laboratory, Kurashiki Central Hospital, Kurashiki 710-8602, Japan. fk1306@kchnet.or.jp
authors.forename: Fusae
authors.initials: F
authors.lastname: Kanemitsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kageoka
mesh_terms: D000369:Aged, 80 and over; D000888:Antibodies, Anti-Idiotypic / Q000097:blood; D001792:Blood Platelets / Q000201:enzymology* / Q000473:pathology; D003402:Creatine Kinase / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000201:enzymology*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; D003402:Creatine Kinase