IgM Gammopathy and the Lupus Anticoagulant Syndrome in Habitual Aborters

Guido Finazzi, MD; Sergio Cortelazzo, MD; Piera Viero, MD; Tiziano Barbui, MD
JAMA. 1986;255(1):39. doi:10.1001/jama.1986.03370010041018.
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To the Editor.—  In their recent article, Gleicher and Friberg1 suggested that an IgM gammopathy may represent an integral part of circulating lupus anticoagulant syndrome (CLAS) associated with pregnancy loss. However, we observed only one case of polyclonal increase of IgM out of four patients with lupus anticoagulant and recurrent abortions. Pertinent data from our patients are summarized in the Table. In addition, we diagnosed Waldenström's macroglobulinemia in a mother of four children with lupus anticoagulant and impaired platelet function but without history of fetal loss. In this patient, immunofluorescence studies revealed platelet-bound IgG. Following elution from platelets, the IgG fraction showed lupus anticoagulant activity.Our observations indicate that IgM gammopathy is not always present in patients with the syndrome of lupus anticoagulant and recurrent abortions. Moreover, the circulating anticoagulant activity does not necessarily rest in the abnormal IgM fraction, when present. Thus, the role of IgM in the


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