IgD myeloma. A study of four cases.
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Biomedical subjects
Publications and source records attributed to E Tonutti.
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The study of T lymphocyte subpopulations defined by monoclonal antibodies in a group of patients with rheumatoid arthritis and a control group indicated no significant differences in the percentages of total T lymphocytes (OKT3+) or helper-inducer lymphocytes (OKT4+). However there was a significant diminution in suppressor-cytoxic lymphocytes (OKT8+) in patients with active forms of the disease. This diminution led to an increase in the proportion of OKT4+/OKT8+ in patients with active R.A. forms compared to both those in remission and the control group.
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The definitive demonstration of the clonal origin of an expanded B or T cell population is achieved by the molecular analysis of B or T cell receptor gene rearrangement. However, in recent years techniques that are both sensitive and relatively easy to carry out have been introduced as the first step to the diagnosis of clonality. These include immunochemical analysis of serum and urine to characterize their monoclonal immunoglobulin components, and immunophenotypic studies of peripheral blood or tissue cells. The most widely used techniques are reviewed here, with particular emphasis on the clinical applications of immunofixation electrophoresis and multiparametric cytofluorimetric procedures.
OBJECTIVES: To define whether Sjögren's syndrome (SS) patients have lymphocytopenia compared to healthy controls, and to assess which lymphocyte subset might be involved. The presence of any concurrent infection was recorded. METHODS: A cohort of ten consecutive patients with SS was studied, and the results were compared with ten sex- and age-matched controls (C). RESULTS: In SS, a significant cytopenia of CD4+ (679 +/- 339 vs 1110 +/- 222 cells/mm3, p < 0.005) and an even more impressive decrease in the CD4+CD45 RA+ (242 +/- 154 vs 491 +/- 190 cells/mm3, p < 0.005) subset was observed. An absolute CD4 lymphocytopenia (CD4+ < 300 cells/mm3) was seen in two patients. In one patient an unusual finding was the expansion of a double positive population of CD4+CD8+ lymphocytes. No striking relationship with any particular infection was shown. A retrospective review of the absolute CD4+ cytopenia in 54 consecutive SS cases revealed a prevalence of 5.5%. CONCLUSION: Some SS patients have T lymphocytopenia which mainly affects the CD4+CD45 RA+ subset. Occasional cases with absolute CD4 lymphocytopenia may also be observed. These patients show some evidence of mild recurrent or chronic, but never severe, opportunistic infections.