Top

BMC Immunology

Published in:

Open Access 01-12-2017 | Research article

IgMk paraprotein from gammopathy patient can bind to cardiolipin and interfere with coagulation assay: a case report

Authors: Xin-yao Wu, Yu-feng Yin, Jia-lin Teng, Li-wei Zhang, Cheng-de Yang

Published in: BMC Immunology | Issue 1/2017

Abstract

Background

The monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein). Some rare cases have revealed the specific affinity of paraprotein as autoantibody. Here we report a patient with monoclonal gammopathy of undetermined significance (MGUS) accompanied by a remarkable increase of anticardiolipin antibody (aCL) and an extensively decreased coagulation factor activity, however, without any clinical signs of antiphospholipid syndrome (APS) and bleeding.

Results

Our further investigation indicated that IgMκ paraprotein of this patient possessed an antibody activity against phospholipids so as to bind to cardiolipin and interfere with coagulation assay in vitro.

Conclusions

This case might be indicative that an abnormality of coagulation tests, disturbed by IgMκ paraprotein, does not predict a risk of bleeding in this patient.

International Myeloma Working G. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol. 2003;121(5):749–57.CrossRef

Kyle RA, Rajkumar SV. Monoclonal gammopathies of undetermined significance: a review. Immunol Rev. 2003;194:112–39.CrossRefPubMed

Caers J, Vekemans M-C, Bries G, Beel K, Delrieu V, Deweweire A, Demuynck H, De Prijck B, De Samblanx H, Kentos A, et al. Diagnosis and follow-up of monoclonal gammopathies of undetermined significance; information for referring physicians. Ann Med. 2013;45(5–6):413–22.CrossRefPubMed

Taher A, Abiad R, Uthman I. Coexistence of lupus anticoagulant and acquired haemophilia in a patient with monoclonal gammopathy of unknown significance. Lupus. 2003;12(11):854–6.CrossRefPubMed

Sallah S, Husain A, Wan J, Vos P, Nguyen NP. The risk of venous thromboembolic disease in patients with monoclonal gammopathy of undetermined significance. Ann Oncol. 2004;15(10):1490–4.CrossRefPubMed

Decaux O, Laurat E, Perlat A, Cazalets C, Jego P, Grosbois B. Systemic manifestations of monoclonal gammopathy. Eur J Intern Med. 2009;20(5):457–61.CrossRefPubMed

Colwell NS, Tollefsen DM, Blinder MA. Identification of a monoclonal thrombin inhibitor associated with multiple myeloma and a severe bleeding disorder. Br J Haematol. 1997;97(1):219–26.CrossRefPubMed

Diminno G, Coraggio F, Cerbone AM, Capitanio AM, Manzo C, Spina M, Scarpato P, Dattoli GM, Mattioli PL, Mancini M. A myeloma paraprotein with specificity for platelet glycoprotein IIIa in a patient with a fatal bleeding disorder. J Clin Invest. 1986;77(1):157–64.CrossRefPubMedPubMedCentral

Spaet TH, Cintron J. Studies on Platelet Factor-3 Availability. Br J Haematol. 1965;11:269–75.CrossRefPubMed

10.

von Landenberg P, Scholmerich J, Andreesen R, Vogelhuber M, Lackner KJ. A case of Waldenstroem’s disease with a monoclonal IgM antiphospholipid antibody. Rheumatol Int. 2002;22(3):129–31.CrossRef

11.

Thiagarajan P, Shapiro SS, De Marco L. Monoclonal immunoglobulin M lambda coagulation inhibitor with phospholipid specificity. Mechanism of a lupus anticoagulant. J Clin Invest. 1980;66(3):397–405.CrossRefPubMedPubMedCentral

12.

Talamo G, Mir MA, Pandey MK, Sivik JK, Raheja D. IgM MGUS associated with anti-MAG neuropathy: a single institution experience. Ann Hematol. 2015;94(6):1011–6.CrossRefPubMed

13.

Forni GL, Pinto V, Musso M, Mori M, Girelli D, Caldarelli I, Borriello A, Ragione FD. Transferrin-immune complex disease: a potentially overlooked gammopathy mediated by IgM and IgG. Am J Hematol. 2013;88(12):1045–9.CrossRefPubMed

14.

Riksen NP, Luken BM, Klasen IS, Voorberg J, Crama N, van Deuren M. Antibodies against the CUB1-2 domains of ADAMTS13 in a patient with benign monoclonal gammopathy: no causal relationship. Haematologica. 2007;92(7):e74–6.CrossRefPubMed

15.

Konrad RJ, Kricka LJ, Goodman DB, Goldman J, Silberstein LE. Brief report: myeloma-associated paraprotein directed against the HIV-1 p24 antigen in an HIV-1-seropositive patient. N Engl J Med. 1993;328(25):1817–9.CrossRefPubMed

Title: IgMk paraprotein from gammopathy patient can bind to cardiolipin and interfere with coagulation assay: a case report
Authors: Xin-yao Wu
Yu-feng Yin
Jia-lin Teng
Li-wei Zhang
Cheng-de Yang
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Immunology / Issue 1/2017
Electronic ISSN: 1471-2172
DOI: https://doi.org/10.1186/s12865-017-0213-0

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

IgMk paraprotein from gammopathy patient can bind to cardiolipin and interfere with coagulation assay: a case report

Abstract

Background

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Helios + Regulatory T cell frequencies are correlated with control of viral replication and recovery of absolute CD4 T cells counts in early HIV-1 infection

Renal allograft rejection, lymphocyte infiltration, and de novo donor-specific antibodies in a novel model of non-adherence to immunosuppressive therapy

Characteristics of the specific humoral response in patients with advanced solid tumors after active immunotherapy with a VEGF vaccine, at different antigen doses and using two distinct adjuvants

Effect of cryopreservation on delineation of immune cell subpopulations in tumor specimens as determined by multiparametric single cell mass cytometry analysis

Recombinant Salmonella expressing SspH2-EscI fusion protein limits its colonization in mice

Monocyte differentiation and macrophage priming are regulated differentially by pentraxins and their ligands

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page