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

BMC Immunol. 2017 Jun 23;18(1):32. doi: 10.1186/s12865-017-0213-0.

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.

Keywords: Antibody; Coagulation; Monoclonal Gammopathy; Paraprotein; Phospholipid.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / metabolism*
  • Blood Coagulation
  • Blood Coagulation Tests / methods*
  • Blood Coagulation Tests / standards
  • Cardiolipins / metabolism*
  • Diagnostic Errors / prevention & control*
  • Humans
  • Immunoglobulin M / genetics
  • Immunoglobulin M / metabolism*
  • Immunoglobulin kappa-Chains / genetics
  • Immunoglobulin kappa-Chains / metabolism*
  • Male
  • Middle Aged
  • Paraproteinemias / blood
  • Paraproteinemias / diagnosis*
  • Protein Binding

Substances

  • Autoantibodies
  • Cardiolipins
  • Immunoglobulin M
  • Immunoglobulin kappa-Chains