Inhibition of fibrin monomer polymerisation by myeloma immunoglobulin.

Abstract:

:Myelomatosis was diagnosed in a 64 year old man on the basis of a serum paraprotein band (type IgG lambda, 42 g/l), plasma cell infiltration of bone marrow, and multiple lytic lesions evident on skull x ray picture. Blood specimens taken into plain glass tubes showed bulky gelatinous clot formation with minimal clot retraction. Coagulation tests were significantly abnormal with an increase in thrombin time, prothrombin time, and reptilase time. The possibility that the paraprotein was interfering with fibrin production was investigated. The rate of fibrin monomer polymerisation (measured turbidometrically) was reduced in patient plasma compared with control plasma. Although purified fibrin monomer prepared from the patient's fibrinogen polymerised normally, the addition of purified paraprotein caused a dose dependent reduction in the rate of polymerisation. These results suggest that the paraprotein was impairing fibrin formation by inhibiting fibrin monomer polymerisation. After chemotherapy the paraprotein concentration decreased and the coagulation results returned to normal.

journal_name

J Clin Pathol

authors

O'Kane MJ,Wisdom GB,Desai ZR,Archbold GP

doi

10.1136/jcp.47.3.266

subject

Has Abstract

pub_date

1994-03-01 00:00:00

pages

266-8

issue

3

eissn

0021-9746

issn

1472-4146

journal_volume

47

pub_type

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