Abstract
BackgroundThe 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.ResultsOur 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.ConclusionsThis case might be indicative that an abnormality of coagulation tests, disturbed by IgMκ paraprotein, does not predict a risk of bleeding in this patient.
Highlights
The monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein)
We hypothesized that the IgMκ paraprotein of this patient possessed a specific affinity for phospholipid, which served as anticardiolipin antibodies and disturb coagulation detection via binding to platelet phospholipid substitute in vitro
Our experiments demonstrated an antibody property of IgMκ paraprotein that can bind to cardiolipin and interfere with assay of coagulation in this patient with monoclonal gammopathy of undetermined significance (MGUS)
Summary
The monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein). Previous study suggested that these disorders in MGUS may be due to the antibody activity of the particular monoclonal immunoglobulin [6]. We described a MGUS patient with significantly increased level of anticardiolipin antibody (aCL) and decreased levels of coagulation factor activity, without any clinical manifestations of antiphospholipid syndrome (APS) and bleeding.
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