M成分に抗マイクロゾーム抗体活性をもつ多発性骨髄腫と橋本病の合併例

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A 57-year-old female suffered from Hashimotos thyroiditis since 1959. When she was hospitalized in Nov. 1979 for acute bronchitis, her home doctor pointed out her sera showed marked hypergammaglobulinemia. She was referred to our hospital for further examination. Her case was diagnosed as multiple myeloma according to the findings; increasement of IgG1, k monoclonal gammaglobulin, increasement of immature plasmacytes in bone marrow and multiple osteolytic lesions in the skull. Her sera also showed anti-microsome antibody activity at a dilution of 1: 25, 600.The monoclonal protein was purified from her sera to testify the presence of anti-microsome antibody activity. The results were as follows.1) Patients purified IgG, F (ab)2 and light chain kappa F (ab)2 showed anti-microsome antibody activity at a dilution of 1: 102, 400, 1: 102, 400 and 1: 25, 600 respectively. However, light chain lambda F (ab)2 did not show this antibody activity.2) Anti-idiotypic antybody was prepared by immunizing rabbit with F (ab)2 fragment of patients IgG followed by absorption with IgG of Cohns fraction II. This anti-idiotypic antibody binded only F (ab)2 of patients IgG but not IgG of Cohns fraction II. This anti-idiotypic antibody inhibited the binding between the monoclonal protein and microsome antigen.These results suggested that patients monoclonal protein was the antibody to microsome.This is the first case reported in the literature whose serum monoclonal protein has been proved to be anti-microsome antibody.

M成分に抗マイクロゾーム抗体活性をもつ多発性骨髄腫と橋本病の合併例

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