ABSTRACT
Although hypercoagulable states are most often associated with venous thrombosis, arterial thromboses are reported in protein S, protein C, and antithrombin III deficiencies, factor V Leiden and prothrombin gene mutations, hyperhomocysteinemia, dysfibrinogenemia, plasminogen deficiency, sickle cell disease, and antiphospholipid antibody syndrome.
Subject(s)
Disseminated Intravascular Coagulation/complications , Stroke/metabolism , Anemia, Sickle Cell/etiology , Antiphospholipid Syndrome/immunology , Antiphospholipid Syndrome/physiopathology , Blood Protein Disorders/classification , Blood Protein Disorders/complications , Blood Protein Disorders/genetics , Blood Protein Disorders/metabolism , Factor V/genetics , Factor V/metabolism , Fibrinogens, Abnormal/genetics , Fibrinogens, Abnormal/metabolism , Humans , Hyperhomocysteinemia/etiology , Hyperhomocysteinemia/genetics , Plasminogen/genetics , Plasminogen/metabolism , Prothrombin/genetics , Prothrombin/metabolism , Stroke/etiology , Stroke/geneticsSubject(s)
Blood Protein Disorders/classification , Blood Protein Disorders/diagnosis , Blood Protein Disorders/pathology , Diagnosis, Differential , Humans , Lymphoproliferative Disorders/classification , Lymphoproliferative Disorders/diagnosis , Lymphoproliferative Disorders/pathology , Monoclonal Gammopathy of Undetermined Significance/classification , Monoclonal Gammopathy of Undetermined Significance/diagnosis , Monoclonal Gammopathy of Undetermined Significance/pathology , Multiple Myeloma/classificationABSTRACT
Asymptomatic forms of monoclonal gammopathies (MG) are recognized with increasing frequency; their recognition and differentiation from the symptomatic forms of MG appear imperative, since the therapeutic approaches are different. Available clinical and laboratory indexes lack specificity required for useful and practical discrimination; presently, we must still rely on the timecourse monitoring of such laboratory values as hemoglobin levels, M-protein concentrations, and presence of Bence Jones proteins. Elucidation of histocompatibility A and W antigenic profiles, as well as the functions and kinetics of B-lymphocytes from such patients, appear most promising. Evidence of the causative role of extrinsic and intrinsic antigenic stimulation in MG production is increasing; segregation into two distinct concentration ranges of M-proteins in the asymptomatic and symptomatic groups suggests two control levels of the expression of immune response (Ir) genes, due to partial or complete derepression of the latent Ir gene function, reflecting "partial" (asymptomatic, benign MG) and "complete" (symptomatic, malignant MG) monoclonal immune responders.
Subject(s)
Blood Protein Disorders/classification , ABO Blood-Group System , B-Lymphocytes/immunology , Bence Jones Protein/analysis , Blood Protein Disorders/diagnosis , Blood Protein Disorders/etiology , Blood Protein Disorders/immunology , Blood Sedimentation , Blood Viscosity , Bone Marrow Examination , Bone Neoplasms/diagnosis , Cell Membrane/immunology , Chromosome Aberrations , Complement System Proteins/analysis , Female , Heavy Chain Disease/diagnosis , Hemoglobins/analysis , Histocompatibility Antigens/analysis , Humans , Immunoglobulin Fragments/analysis , Lymphocyte Activation , Lymphocyte Culture Test, Mixed , Male , Multiple Myeloma/diagnosis , Myeloma Proteins/analysis , Serum Albumin/analysis , Skin Tests , Waldenstrom Macroglobulinemia/diagnosisSubject(s)
Arteriosclerosis/prevention & control , Diabetic Angiopathies/prevention & control , Hyperlipidemias/therapy , Arteriosclerosis/etiology , Blood Protein Disorders/classification , Body Weight , Cholestyramine Resin/therapeutic use , Clofibrate/therapeutic use , Diabetes Mellitus/blood , Diabetic Angiopathies/diet therapy , Diabetic Angiopathies/etiology , Dietary Carbohydrates , Hypercholesterolemia/classification , Hypercholesterolemia/diet therapy , Hyperlipidemias/complications , Hyperlipidemias/diet therapy , Lipoproteins/blood , Lipoproteins, LDL/blood , Nicotinic Acids/therapeutic use , Thyroxine/therapeutic use , Triglycerides/bloodABSTRACT
The author reviews the present state of knowledge of value in rheumatology concerning serum immunoglobulins, their structure, their cellular biosynthesis, and their relation to membrane immunoglobulins of the B lymphocytes. He then examines the concept of dysglobulinaemia and explains why the terms monoclonal immunoglobulin and monoclonal immunoglobulinopathy are preferable to dysglobulinaemia and paraprotein. The clinical and immunochemical classification of monoclonal immunoglobulins, the problem of amylosis, and the relationship with plasmocytic dyscrasias and with the cryoglobulins are then discussed. Afterwards the pathogeny of these affections is briefly considered.