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Cryoglobulinemia Classification Types Type 1: Monoclonal IgM (rarely IgG/lgA) • Raynaud phenomenon, Digital ulcers/gangrene, Livedo reticularis, Hyperviscosity
(rarely IgG/lgA ... > 4 g/dL) Mixed ... and polyclonal IgG ... and polyclonal IgG ... and polyclonal IgG
IGG-4 RELATED DISEASE WHAT? • A chronic, immune-mediated fibroinflammatory disease with tumefactive infiltration of IgG4+ plasma cells
IGG-4 RELATED DISEASE ... infiltration of IgG4 ... lesions - IgG4 ... Biliary Tract: IgG4 ... -4 #IGG4 #Diagnosis
Clinical Manifestations and Diagnosis of Lyme Disease - Borreliosis Erythema migrans - 3-32 days (median: 7-10 days)
High specific IgG ... Specific serum IgG ... years (median: 4- ... High specific IgG ... Lyme carditis - 4
Warm Antibody Autoimmune Hemolytic Anemia 1) DIAGNOSE AIHA • Anemia: macrocytic > normocytic, ↑ reticulocytes •
direct Coombs • IgG ... Splenectomy 4
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
- IgG typically ... diagnosis depends on 4 ... Abs (rare) - IgG ... AST > 5x ULN AND IgG
Summary table of types of hypersensitivity reactions. Type 1 - Mediators: lgE - Antigen Form: Soluble
- Mediators: IgG ... / IgM - Antigen ... Mechanism of Action: IgG ... erythematosus Type 4
Common Variable Immunodeficiency (CVID) What? CVID: Immunodeficiency disorder with hypogammaglobulinemia -> increased infection risk secondary to impaired B-cell
: • Low serum IgG ... ) • Low serum IgA ... and/or IgM, age ... greater than 4 ... trough levels of IgG
IgG4-Related Disease Clinical history: Man, 60 years, multiorgan involvement, unique or multiple inflammatory pseudotumor 4 phenotypes: •
IgG4-Related Disease ... inflammatory pseudotumor 4 ... node), high serum IgG4 ... with increased IgG4 ... Mettler_K1000 #IgG4
Eosinophilia - Differential Diagnosis Algorithm Idiopathic Eosinophilia Primary Eosinophilia: • Primary hypereosinophilic syndrome • Eosinophilic Leukemia • MPN/MDS
Rheum/AI: EGPA, IgG ... -4 disease, Behcet
Cold Agglutinin Disease 3 Types of Cold Sensitive Antibodies: 1. Cold Agglutinins (CAD) 2. Donath-Landsteiner
Idiopathic monoclonal IgM ... titer of ≥64 at 4° ... negative anti-lgG ... Immunoglobulin M (IgM ... Donath-Landsteiner (IgG
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