A 49 yr old woman with severe hemolytic anemia had marked depression of serum IgG and IgA along with monoclonal serum IgM detectable in both high and low molecular weight forms. Antiglobulin tests by instrumented and manual techniques showed only IgM coating of the erythrocytes and an eluate contained low molecular weight IgM. The IgM fraction of the patient's serum contained anti I agglutinins active at 37°C. Lymphocyte response to Concanavalin A was diminished, whereas response to phytohemagglutinin and pokeweed mitogen was normal. Blood monocyte Fc receptor activity was increased in comparison to controls. The finding of a low molecular weight IgM possibly related to hemolysis in addition to 19S IgM anti I activity with high thermal optimum in a patient with hypogammaglobulinemia represents an unusual form of immune hemolytic anemia.
ASJC Scopus subject areas
- Immunology and Allergy
- Pathology and Forensic Medicine