David E. Normansell

The IgG subclass specificity of anti IgG immunoglobulin rheumatoid factors

19S IgM anti-IgG immunoglobulin rheumatoid factors, isolated from the sera of two patients with rheumatoid arthritis, were reacted with 7S myeloma IgG globulins of four subclasses in a direct non precipitating reaction. IgG myelomas of subclasses 1, 2 and 4 reacted with equal binding constant (K0 = 1−3 × 105 L/M) whereas IgG myelomas of subclass 3 showed no observable reaction with either of these RF preparations.

Anti-γ-globulins in rheumatoid arthritis sera—I. Studies on the 22s complex

Abstract Association constants were measured for the interaction between anti-λ-globulin rheumatoid factors (RF) and pooled normal human λG-globulin. RF preparations isolated from four rheumatoid arthritis sera gave closely similar association constants. The interaction was not influenced by the type of λG-globulin used: similar binding was found for pooled normal, individual normal and autologous λG-globulin. There was no effect of rotor speed and only a small effect of temperature; the reaction was driven mainly by entropy. Cleavage of pentameric RF into 7 S subunits did not affect the binding strength per bond.

Gamma heavy chain disease: Report of a case associated with trisomy of chromosome 7

A case of gamma heavy chain disease is reported in a 52-year-old white male who presented with fever and generalized lymphadenopathy. A lymph node biopsy showed malignant lymphoma. A partial transient response was obtained with cyclophosphamide, vincristine, prednisone, and doxorubicin. He died 3 months after diagnosis from disease progression and infectious complications. Chromosome analysis of cells from an involved lymph node showed the presence of trisomy 7. Chromosome abnormalities have been reported in three of ten previously published cases of gamma heavy chain disease. Trisomy of chromosome #7 has not previously been reported.

Low molecular weight rheumatoid factors in rheumatoid arthritis sera

Abstract Low mol. wt (7S IgG) anti IgG rheumatoid factors (RE) were isolated from the serum of two patients with rheumatoid arthritis. The interaction of these RF preparations with the Fc fragment of human IgG was studies in the ultracentrifuge and compared with 19S IgM RF isolated from the same sera. The measured binding constant or IgG RF was identical to that of the IgM RF in one patient, whereas in the other patient, the IgG RF exhibited a lower binding constant than did the IgM RF.

Intermittent Claudication as the Presenting Symptom in Primary Amyloidosis

B.F. Schneider, PhD, MD, Department of Radiology, Radiation Oncology – Box 383, University of Virginia Health Science Center, Charlottesville, VA 22908 (USA) Intermittent claudication is a symptom of circulatory insufficiency that develops primarily in muscles of the lower extremities. It is most frequently associated with atherosclerosis, but may also occur with other vascular disorders such as giant cell arteritis, thromboangiitis obli-terans, Takayasu disease and Raynaud disease, as well as with stenosis of the lumbar spinal canal [1]. Here we report on a patient whose symptoms of intermittent claudication appear to be due to amyloid angiopathy; moreover, this appears to be the first symptom of this patient’s previously unrecognized primary amyloidosis. A 77-year-old man presents with a 4-year history of exercise-induced pain in his calf muscles bilaterally, extending to his thighs and buttocks. These symptoms now occur after walking approximately 50 yards and are relieved completely by resting for a few minutes. He also has pain in both upper extremities with minimal exercise, relieved by rest. Approximately 18 months ago he underwent a la-minectomy of L4 and decompression of L3-4 and L4-5 for spinal stenosis, but his symptoms remained unchanged. Neurologic reevaluations indicate that his persisting symptoms of intermittent claudication are not due to spinal stenosis. Multiple peripheral vascular studies, including an angiogram and ankle brachial index with exercise, have all indicated no major vascular obstruction. On physical exam he is normotensive, with no bruits and nontender temporal arteries. The liver is moderately enlarged, and the spleen is not palpable. Straight leg raise is negative. Motor and sensory examinations are intact throughout. There is some degree of cyanosis of his feet, particularly in the dependent position, and the distal extremities are cool, but distal pulses and capillary refill are normal. Laboratory tests reveal a blood urea nitrogen of 28 mg/dl and a creatinine of 1.7 mg/dl. Blood count reveals a mild anemia with a hemoglobin of 11.9 g/dl and hematocrit of 36%. The white blood cell count is 4,300/ml with 22% lymphocytes, 17% monocytes, 5% eosinophils and 1% ba-sophils. The platelet count is 37,000/ml. Serum protein electrophoresis shows increased ß-glob-ulins (1.19 g/dl, normal 0.6-1.10) with normal levels of albumin, αr, α2and γ-globulins. Quantitative levels of IgG, IgA, IgM, k and λ

The seroprevalence of cytomegalovirus among Virginia State Prisoners

A prevalence serosurvey of adult male prisoners entering the Virginia State Prison was conducted to evaluate the epidemiology of cytomegalovirus within this population. Four hundred and forty-five (97%) of 459 male inmates provided serum for analysis and 427 completed a detailed demographic questionnaire. Sera were tested for cytomegalovirus by passive latex agglutination and 64% were reactive. Multivariate discriminant analysis showed an independent association of seropositivity with age, non-white race, and a history of gonorrhea. There was no apparent contribution from admitted homosexual contact though this may have been under-reported. There was no correlation of seropositivity with intravenous drug use or with the length or number of prior incarcerations. Prisoners possess the same correlates for cytomegalovirus seropositivity as the general adult population; past imprisonment did not independently contribute to cytomegalovirus seropositivity.

Subpopulations of human peripheral blood lymphocytes

Abstract Multiple staining protocols have been developed for the classification of subpopulations of human peripheral blood lymphocytes. Of the non-T (E−) cells, roughly half (10–20% PBL) have receptors for complement components as detected with complement-coated zymosan particles, but do not show Fc receptors as detected with Ripley IgG-coated human RBC. The other half are C−, Fc+, with a small percentage possessing both receptors. The C+, Fc− cells can be subdivided into cells which are IgM+ (75%) or IgM−. Cells with Fc receptors detected with aggregated IgG were IgM+.

In a Neonate with Down Syndrome Immunophenotypic Studies

This report describes the results of bone marrow leukocyte immunophenotypic studies, DNA index measurement, and chromosome analysis in a newborn with Down syndrome and transient myeloproliferative disorder. The infants initial leukocytosis with immature cells in the peripheral blood and thrombocytopenia resolved without treatment by 6 months of age, and he was well at 2 years of age. The lack of specific reactivity between the patients morphologically immature cells and multiple monoclonal antibodies directed against lymphoid and myeloid leukemia cells may be characteristic of this disorder. Other cases should be examined for immunophenotype to correlate the results with chromosomal analysis and to provide a basis for comparison in those who subsequently develop true acute leukemia.This report describes the results of bone marrow leukocyte immunophenotypic studies, DNA index measurement, and chromosome analysis in a newborn with Down syndrome and transient myeloproliferative disorder. The infants initial leukocytosis with immature cells in the peripheral blood and thrombocytopenia resolved without treatment by 6 months of age, and he was well at 2 years of age. The lack of specific reactivity between the patients morphologically immature cells and multiple monoclonal antibodies directed against lymphoid and myeloid leukemia cells may be characteristic of this disorder. Other cases should be examined for immunophenotype to correlate the results with chromosomal analysis and to provide a basis for comparison in those who subsequently develop true acute leukemia.

Effects of dexamethasone therapy on serum immunoglobulin levels and peripheral cell counts in women undergoing conservative benign gynecologic surgery

Twenty women undergoing conservative gynecologic surgery were treated perioperatively with high-dose dexamethasone (DEX) for 72 hours. Serum immunoglobulin levels (IgG, IgM, IgA) and peripheral cell counts, including lymphocyte subpopulations, were measured in each patient during the immediate preoperative and postoperative periods as well as 5 to 8 weeks later. These results were compared with the levels of a control population of 16 women undergoing conservative, non-pregnancy-related gynecologic surgery for benign conditions. There was a decrease in the level of all serum immunoglobulins measured in the immediate postoperative period in both groups, with a greater statistical decrease in the control group (P less than 0.001). statistically significant transient alterations in the peripheral cell counts occurred in the DEX group, as compared with the control group (P less than 0.001). The use of DEX was not associated with any postoperative infectious morbidity.

Pocket guide to clinical immunology

This publication will do for the field of clinical laboratory immunology what the Pocket Guide to Clinical Microbiology has done for clinical microbiology. Intended as a convenient guide to the use and interpretation of immunologic tests, it covers immunologic diseases and other diseases in which immunologic tests are useful for diagnosis and focuses on the appropriate use of such tests. Providing a ready reference to the most common immunological tests in use today, it allows the reader to judge the suitability and appropriateness of tests ordered and aids in their interpretation. Suggestions for auxiliary tests are also offered. A Quick Reference is provided at the beginning of each topic, leading to a more detailed description of each point. A list of common abbreviations used in clinical immunology and a thorough glossary are also included. Electronic only, 280 pages, full-color insert, glossary, index.