Immunoprotein

Abstract: A healthy 43-year-old officer of a merchant ship at sea developed pain, redness, and photophobia in his right eye. During the next 2 weeks, he noted the presence of a band of opacity spreading from his temporal limbus toward his central cornea. His episcleral vessels were engorged in a distribution contiguous with the peripheral, sectorial, fleck-like corneal opacities. The opacity had progressed during topical and systemic antibiotic therapy, but halted with use of topical corticosteroids. Systemic evaluation showed mild IgM monoclonal gammopathy. Transmission electron microscopy of a corneal biopsy specimen revealed electron-dense fibrils identified as immunoprotein. To our knowledge, this is the first report of a case of acute unilateral deposition of corneal immunoprotein in a patient with monoclonal gammopathy. Clinicians should begin with a broad differential diagnosis when evaluating patients with corneal opacity.

Abstract: The aetiology of Reiter's syndrome (RS) is unknown. In order to evaluate the role of immunological mechanisms in this disease we performed synovial biopsies on 12 patients with RS looking for deposition of immunoglobulins and complement components in synovial tissue. By immunofluorescent techniques 11 synovia were found to have immunoprotein deposition. IgM deposition was found around vessels in 8 synovia and in the interstitial tissue in 4. C3 was present perivascularly in 11 cases; in 4 of those there was also staining in the interstitial tissue. No immunoproteins were found in infiltrating or synovial lining cells. The finding of immunoproteins in the synovium of the majority of patients with RS suggests that immunological mechanisms are involved in the pathogenesis of this disease.

Abstract: Brain biopsy specimens from a 38-year-old woman with adversive seizures and bifrontal mass lesions evident on computed tomographic scans showed extracellular and intracellular deposits of crystallized protiens. These were morphologically identical to the immunoglobylin crystals seen in reactive or neoplastic plasma cells and by peroxidase-antiperoxidase methods were found to contrain polyclonal immunoglobulins. In addition, severe angiitis of the intracerebral blood vessels was present.