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IgG2 deficiency in primary Sjögren's syndrome and hypergammaglobulinemic purpura
Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Nephrology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
1994 (English)In: Clinical Immunology and Immunopathology, ISSN 0090-1229, E-ISSN 1090-2341, Vol. 70, no 1, 60-65 p.Article in journal (Refereed) Published
Abstract [en]

Total IgG and IgG subclasses were studied in 34 patients with primary Sjogren's syndrome and 4 with hypergammaglobulinemic purpura. Total IgG was elevated in 30/34 patients with Sjogren's syndrome. IgG1 increase was responsible for the main part of total IgG increase, contrasting with low levels of IgG2. The difference in IgG1/IgG2 ratio between 38 patients as a group and 40 normal controls was statistically highly significant, but was not seen in all patients. Six patients had markedly low levels of IgG2, but only two had severe repeated respiratory infections. These observations probably reflect selective autoantibody restiction to the IgG1 subclass. We conclude that patients with Sjogren's syndrome may be IgG2 subclass deficient despite elevated levels of total IgG, but also that such deficiency in most instances does not cause a tendency to infections. IgG subclass analysis may be of value to characterize polyclonal IgG increase, since IgG1 subclass predominance often indicates autoimmune disease.

Place, publisher, year, edition, pages
1994. Vol. 70, no 1, 60-65 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-79906DOI: 10.1006/clin.1994.1011OAI: oai:DiVA.org:liu-79906DiVA: diva2:544550
Available from: 2012-08-15 Created: 2012-08-15 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Immunoglobulins, immunoglobulin subclass-distributions and serologic markers in some renal and systemic disorders
Open this publication in new window or tab >>Immunoglobulins, immunoglobulin subclass-distributions and serologic markers in some renal and systemic disorders
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In this study we evaluated pathogenetic factors and possible mediators of renal and systemic disorders where immunologic mechanisms might be of importance.

An abberant immunoglobulin and IgG-subclass distribution was detected in 103 patients with primary and secondary glomerulonephritis as well as in 38 patients with the systemic disease primary Sjögren 's syndrome or purpura hypergammaglobulinemica (elevated IgG1 and low IgG2 ).

The drug hydralazine, an anti-hypertensive, was considered to cause renal disease on an immunologic base in 17 patients, with autoantibody production (mainly ANA and antibodies to myeloperoxidase).

Dialysis-patients showed adequate antibody responses to vaccination against pneumococci but low responses against hepatitis B, while the IgG-subclass response of the hepatitis B antibody (anti-HBs) was low, but not shown to be significantly different from that of healthy adults.

A therapeutical removal of igG-antibodies with immunoadsorption or plasmapheresis was considered to have a possible adjuvant effect to medical immunosuppressive treatment alone in 44 patients with rapidly progressive glomerulonephritis.

Hepatitis C virus (HCV) is common in dialysis patients and renal transplant recipients. In 20 anti-HCV positive sera from 1988-91 recombinant immunoblott assay (RIBA) was positive in 8 cases and indeterminate in 7, while HCV RNA was present in 13/20 tested sera. In October 1991 17% of our hemodialysis patients were verified or suspected carriers while 11% were verified or suspected carriers in January 1997. Genotype 2b was found in 13/24 tested cases and in 7 amplifiable 2b sequences a strong phylogenetic relationship occurred. In 8 out of 12 RIBA-3 indeterminate sera HCV-RNA was still positive. Awareness and preventive measures limited transmission between patients.

Indeterminate RlBA-results should, also with modem assays, be regarded with caution due to the relative immunodeficiency of uremic patients.

In conclusion renal and systemic diseases may affect the serum immunoglobulins and immunoglobulin G-subclasses, while a study of the specific antibody subclass distributions (anti-HBs) showed no difference in renal (dialysis) patients and healthy adults. Medication (hydralazine) and infection may be triggering factors of various forms of glomerulonephritis. Uremia affects the antibody responses to hepatitis C in dialysis patients. The extent of renal disease as well as the possibility of therapeutic removal of antibodies is also important for the immunologic responses of such disorders.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 87 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 646
Keyword
Immunoglobulins, immunoglobulin-subclass distribution, hydralazine, ANCA, anti-:MPO, primary SjOgren's syndrome, hepatitis B vaccination, anti-HBssubclasses, immunoadsorption, plasmapheresis, antibodies, hepatitis C virus, transmission, recombinant immunoblot assay, hepatitis C genotype
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27455 (URN)12108 (Local ID)91-7219-747-1 (ISBN)12108 (Archive number)12108 (OAI)
Public defence
2000-12-15, Berzeliussalen, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-15Bibliographically approved

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Almroth, Gabriel

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