tailieunhanh - báo cáo khoa học: "Prozone effect of serum IgE levels in a case of plasma cell leukemia"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Prozone effect of serum IgE levels in a case of plasma cell leukemia | Talamo et al. Journal of Hematology Oncology 2010 3 32 http content 3 1 32 JOURNAL OF HEMATOLOGY ONCOLOGY CASE REPORT Open Access Prozone effect of serum IgE levels in a case of plasma cell leukemia Giampaolo Talamo William Castellani Nathan G Dolloff Abstract We describe a case of multiple myeloma MM and secondary plasma cell leukemia PCL secreting IgE-kappa immunoglobulin. To our knowledge only 2 cases of IgE-producing secondary PCL have been reported in the medical literature. In our patient the only tumor marker available for monitoring the therapeutic response to chemotherapy and allogeneic stem cell transplantation was the quantitative M component at serum protein electrophoresis SPEP because serum free light chains were in the normal range Bence-Jones proteinuria was absent and quantitative serum IgE levels provided inaccurate and erratic results due to the prozone effect. This is a laboratory phenomenon that occurs when antigen excess interferes with antibody-based methods requiring immune complex formation for detection. It is important to recognize the presence of a prozone effect because it can produce falsely normal results and therefore it could lead clinicians to incorrect assessment of the response to therapy. Background IgE myeloma is a very rare subtype of MM and it represents of all plasma cell dyscrasias 1 . Since the first case was described in 1967 2 approximately 47 cases of IgE MM have been reported in the literature 3-6 . IgE antibodies are named from the ragweed E antigen which was used for their isolation and they are involved in allergic responses atopic conditions helminthic and respiratory infections and chronic inflammatory diseases 7 . It is important to note that commonly available serum immunofixation IFE testing screens only for monoclonal IgG IgM and IgA chains. Therefore IFE specific for IgD and IgE should be requested when these rare subtypes are suspected . when a monoclonal protein has been detected .

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