Clinical immunobiology. Vol. 3 by Fritz H. Bach, Robert A. Good

By Fritz H. Bach, Robert A. Good

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Background IgG was clearly below the age-matched control levels in most of these IgG myeloma sera regardless of the subclass to which the myeloma protein belonged. In general, the levels of all three subclasses of the background IgG were reduced in a balanced way. No tendency for preservation of one particular subclass could be noticed. Between the concentrations of the myeloma proteins and background IgG an inverse relationship was observed: In most sera with high mono­ clonal IgG peaks, background IgG was reduced to 50% or less of the corresponding normal values, whereas in sera with only moderate or small monoclonal gradients, background IgG was closer to normal values.

Hence in those instances (1-2%) where the clinical and patho- EVALUATION OF HOMOGENEOUS IMMUNOGLOBULINS 35 logical picture is typical in the absence of a spike, the diagnosis should still be made ( Franklin, 1974 ). This occurs either in instances in which the cells have been dedifferentiated so that they no longer make H or L chains or occasionally in patients where there is a block in secretion and where the cells are filled with a monoclonal protein when examined by immunofluorescence. Most of these subjects have depressed immunoglobulins and suffer from hypogammaglobulinemia with a depression of all classes of immunoglobulins.

It was reported that IgG2 concentrations are significantly lower in cord than in maternal sera and that the placenta might act as a selective barrier for this subclass. This hypothesis, however, could not be confirmed by various other studies, including the data mentioned above. Typing for genetic markers of IgG2 molecules in fact provided additional evidence that IgG2 concentrations in maternal and fetal sera at the end of gestation are similar. There is general agreement that IgG3 and IgG4 levels are identical in maternal and cord sera.

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