Transient appearance of creatine kinase-linked immunoglobulin in the serum of a patient with facial contusion.
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The patient, 50-year-old woman, was admitted to the hospital because of contusion of her right face. She was mentally retarded from birth and could not speak. One day before admission, she fell down and hit her right face on the ground. On admission, her right face was distended and could not open her right eye and fever developed. On laboratory examinations we found the pyuria and the elevation of the concentration of serum creatine kinase (CK), GOT and LDH. As the diagnosis of urinary tract infection was made and antibiotics was administered, she became afebrile within a few days. Myocardial infarction was ruled out by electrocardiograms. Electrophoretic analysis of CK revealed the extra-band between CK-MM and CK-MB. Thin-layer gel filtration using Sephadex G-200 superfine revealed the presence of high molecular weight form of CK. The high molecular weight form of CK was identified as the CK-linked immunoglobulin (IgA-lamda) by immunological analyses. The concentration of serum CK was down to normal range on the 20th day after admission when she recovered, and we could not detect the CK-linked immunoglobulin at that time.The CK-linked immunoglobulin was found in the sera of patients with muscle diseases, myocardial infarction, ulcerative colitis and malignancies and so on, but there was only one report that it was found in the serum of a patient with muscle contusion. So, this case was thought to be a very rare case.The mechanism of the appearance of CK-linked immunoglobulin is still unknown. Someone says that the non-specific reaction of the body is thought to be its mechanism, but others say that the immunological reaction may be involved in its mechanism. As CK-linked immunoglobulin is not detected at all in the sera of patients with myocardial infarction whose concentration of serum CK rises and falls rapidly like this case, we think that the immunological reaction may be involved in its mechanism.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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