101. Molecular study of an IgG1κ cryoglobulin yielding organized microtubular deposits and glomerulonephritis in the course of chronic lymphocytic leukaemia
- Author
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Michel Cogné, François Paraf, H. R. Galea, Dominique Bordessoule, Jean-Claude Aldigier, Guy Touchard, Franck Bridoux, Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), and Université de Limoges (UNILIM)
- Subjects
MESH: Immunoglobulin Light Chains ,MESH: Neoplasm Proteins ,Male ,Models, Molecular ,Pathology ,MESH: Sequence Homology, Amino Acid ,Protein Conformation ,Chronic lymphocytic leukemia ,Immunoglobulin Variable Region ,MESH: Immunoglobulin Variable Region ,MESH: Amino Acid Sequence ,Kidney ,Microtubules ,Pathogenesis ,Cryoglobulin ,MESH: Protein Conformation ,Glomerulonephritis ,MESH: Cryoglobulins ,Immunology and Allergy ,MESH: Leukemia, Lymphocytic, Chronic, B-Cell ,Cryoglobulins ,MESH: Crystallization ,MESH: Immunoglobulin G ,MESH: Middle Aged ,Chemistry ,MESH: Microtubules ,Hyperplasia ,Middle Aged ,MESH: Glomerulonephritis ,Neoplasm Proteins ,medicine.anatomical_structure ,Cryoglobulinemia ,Monoclonal ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Crystallization ,Immunoglobulin Heavy Chains ,Hydrophobic and Hydrophilic Interactions ,MESH: Models, Molecular ,MESH: Immunoglobulin Heavy Chains ,medicine.medical_specialty ,NLM ,MESH: Cryoglobulinemia ,Immunology ,Molecular Sequence Data ,Static Electricity ,MESH: Immunoglobulin kappa-Chains ,MESH: Sequence Alignment ,MESH: Microscopy, Electron ,Immunoglobulin light chain ,Immunoglobulin kappa-Chains ,MESH: Electrostatics ,medicine ,Humans ,Amino Acid Sequence ,B cell ,MESH: Hydrophobicity ,MESH: Molecular Sequence Data ,MESH: Humans ,Sequence Homology, Amino Acid ,MESH: Kidney ,Original Articles ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,MESH: Male ,Microscopy, Electron ,Immunoglobulin G ,Immunoglobulin Light Chains ,Sequence Alignment - Abstract
SUMMARYGlomerulonephritis with organized microtubular monoclonal immunoglobulin deposits (GOMMID) and glomerulonephritis related to type I cryoglobulin are well-known but rare complications of B cell derived chronic lymphocytic leukaemia. In these disorders, monoclonal Ig have never been studied at the molecular level. We conducted a pathological and molecular analysis in a patient with chronic lymphocytic leukaemia, glomerulonephritis and a single circulating monoclonal Ig. Unusual IgG1κ kidney deposits were observed. The heavy and light chain variable region sequences of that cryoprecipitating monoclonal Ig were characterized. Light microscopy revealed glomerulonephritis typical of cryoglobulinaemia, with neutrophil and macrophage infiltration, endocapillary hyperplasia and few protein thrombi. Electron microscopic study clearly evidenced numerous subepithelial mixed granular and organized deposits with a unique microtubular organization, reminiscent of the GOMMID. The Ig molecule sequence revealed alterations of charge and hydrophobicity potentially promoting a crystal-like aggregation and the aggregation of microtubules. This description suggests that common mechanisms are involved in various forms of precipitation and/or deposition of complete Ig molecules, with a variable extent of organization and with a possible overlap between pathological patterns of either glomerulonephritis with microtubular deposits or type I cryoglobulinic glomerulonephritis.
- Published
- 2002