RESUMO
BACKGROUND: Korea is an endemic area of scrub typhus and it is a common seasonal febrile illness. Although, various humoral immune responses to scrub typhus have been documented, no association between gammopathy and scrub typhus has ever been reported. We analyzed the incidences and types of monoclonal and biclonal gammopathies in scrub typhus for better coping with those gammopathies in scrub typhus. METHODS: Anti-Orientia tsutsugamushi antibody-positive sera identified by indirect immunofluorescence assay were acquired from 40 patients with confirmed scrub typhus. Monoclonal and biclonal gammopathies were screened by protein electrophoresis and were confirmed using immunofixation electrophoresis (IFE). Laboratory findings on admission of the patients with monoclonal or biclonal gammopathy were investigated retrospectively to characterize the gammopathies. RESULTS: Monoclonal or biclonal gammopathies were detected in 30% (12/40) of patients with scrub typhus (IgG-lambda, 40%; IgG-kappa, 30%; IgM-kappa, 10%; IgM-lambda, 10%; IgA-kappa, 5%; IgA-lambda, 5%). Concentrations of clonal immunoglobulin were less than 3 g/dL in all gammopathies, and hypercalcemia was not detected in any of the patients. CONCLUSIONS: Our results suggest possible association between gammopathies and scrub typhus. Further studies in larger series will be needed for exact incidence and clinical course of gammopathies in scrub typhus.
Assuntos
Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Cadeias Pesadas de Imunoglobulinas/sangue , Cadeias Leves de Imunoglobulina/sangue , Imunoglobulina M/sangue , Incidência , Orientia tsutsugamushi/imunologia , Paraproteinemias/complicações , Estudos Retrospectivos , Tifo por Ácaros/complicaçõesRESUMO
The frequency of expression of immunoglobulin (Ig) light and heavy chain isotypes was analyzed in myeloma proteins (M-proteins) from sera of 40 Indian patients with clinically established multiple myeloma. Patients samples were screened by a combination of electrophoresis, immunoelectrophoresis (IEP) and ELISA techniques in this study. We found that majority of the myeloma proteins (58%) were of the IgG isotype followed by IgA (24%) and biclonal gammopathy associated with IgG and IgA (5%). Both kappa and lambda light chains were associated with the heavy chain isotypes. We recommend the triangular combination for detection of M-proteins and biclonal gammopathy of cancerous plasma cells as biomarkers for diagnosis of myeloma.