Crystallocryoglobulinemia resulting from human monoclonal antibodies to albumin

Two patients had a previously unrecognized form of crystallocryoglobulinemia. Their clinical presentations were similar, consisting of necrotizing vasculitis and purpura involving the legs. Analysis of each cryoglobulin complex showed that two components, albumin and a monoclonal IgG-lambda, were pr...

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Bibliographic Details
Published inAnnals of internal medicine Vol. 99; no. 5; p. 601
Main Authors Mills, L E, Brettman, L R, Jentoft, J E, Viner, E D, Bernier, G M
Format Journal Article
LanguageEnglish
Published United States 01.01.1983
Subjects
Adult
Antibodies, Monoclonal - analysis
Autoantibodies - analysis
Cryoglobulinemia - complications
Cryoglobulinemia - immunology
Crystallization
Female
Humans
Immunoglobulin G - analysis
Leg - blood supply
Male
Paraproteinemias - immunology
Purpura - etiology
Serum Albumin - immunology
Vasculitis - etiology
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Summary:Two patients had a previously unrecognized form of crystallocryoglobulinemia. Their clinical presentations were similar, consisting of necrotizing vasculitis and purpura involving the legs. Analysis of each cryoglobulin complex showed that two components, albumin and a monoclonal IgG-lambda, were present, and both components were needed in a fixed ratio for precipitation. In addition, cryoprecipitation occurred in serum, but not plasma, due to citrate inhibition of complex formation. Our findings suggest that the monoclonal IgGs have the properties of antibodies directed specifically against a calcium-dependent antigenic site on human albumin, and that the resultant IgG-lambda-albumin immune complexes crystallized in the cold.
ISSN:0003-4819
1539-3704
DOI:10.7326/0003-4819-99-5-601