September 1971

IgM Heavy Chain Fragments in Waldenström's Macroglobulinemia

Author Affiliations

Chicago; Berwyn, Ill; Chicago

From the Department of Medicine, University of Illinois Abraham Lincoln School of Medicine and Veterans Administration West Side Hospital, Chicago (Drs. Bhoopalam and Heller and Mr. Yakulis), and the Laboratory Service, MacNeal Memorial Hospital, Berwyn, Ill (Dr. Lee). Dr. Lee is now with the Jacksonville State Hospital, Jacksonville, Ill.

Arch Intern Med. 1971;128(3):437-440. doi:10.1001/archinte.1971.00310210113013

Waldenström's macroglobulinemia is an immunoproliferative disorder characterized by the presence of large amounts of monoclonal macroglobulin (IgM) in the serum, apparently produced by abnormally proliferating lymphocytes.1 While in the original description of Waldenström the number of lymphocytes was not increased in the peripheral blood, the bone marrow showed characteristic lymphocytic infiltrations and in later reports on macroglobulinemia the disease was associated with peripheral lymphocytosis.2 Thus, macroglobulinemia has variable morphologic manifestations.

IgM consists of five subunits which have the general structure of all immunoglobulins, namely a pair of type specific heavy chains and a pair of light chains of either the κ type or the λ type. Five such subunits combine to form an IgM molecule (μ2 κ2)5 or (μ2 λ2)5. In 20% to 30% of the patients Bence Jones protein is also present.3 Most patients also have traces of uncombined subunits (IgMs), but free μ chains in this disease have not

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