We are pleased to respond to the letter by Finazzi et al about our article. We never intended to suggest that an IgM gammopathy needs to occur in every patient with a circulating lupus anticoagulant syndrome and pregnancy loss. Our attention to the phenomenon arose when we noticed an IgM gammopathy in the four sequential patients described in our article. We made the point that the incidence of IgM gammopathy in patients with CLAS still needs to be established.Finazzi et al confirmed our observation by reporting one IgM gammopathy in four patients with this syndrome. Since our original publication we have seen a considerable number of additional patients with CLAS. The presence of an IgM gammopathy was observed in some but not all of these patients. The incidence still needs to be established. Immunoglobulin electrophoresis should represent an integral part of the workup of the patient with
Gleicher N, Friberg J. IgM Gammopathy and the Lupus Anticoagulant Syndrome in Habitual Aborters-Reply. JAMA. 1986;255(1):39. doi:10.1001/jama.1986.03370010041019
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