Multiple Autoimmune Propensity and B-Non-Hodgkin Lymphoma: Cause or Effect?

Table 1

Patient’s laboratory findings. Column A: on admission, column B: 6 weeks after initiation of prednizolone, column C: 1 month after the third cycle of chemotherapy (bortezomide, rituximab, and dexamethasone).

	A	B	C		A	B	C		A	B	C
WBC; (4,5–10,5 × 10^3/𝜇L)	10,2	6,4	6,7	Glucose; (75–110 mg/dL)	106	101	88	IgG; (847–1690 mg/dl)	1220	967	1040
NE; (1,5–6,5 × 10^3/𝜇L)	6,7	3,68	3,7	Urea; (10–43 mg/dL)	46	20	27	IgA; (99–300 mg/dl)	299	290	161
LY; (1,2–3,8 × 10^3/𝜇L)	2,9	2,32	2,9	Creatinine; (0,66–1,1 mg/dL)	0,96	0,76	0,7	IgM; (64–249 mg/dl)	757	721	350
HCT; (36–46%)	17,5	43,5	43	Total protein; (6,4–8,3 g/dL)	7,1	8,1	7,2	Direct Coombs’test	+++	++	++
HGB; (12–16,0 g/dL)	5,7	14,6	14,1	Albumin; (3,5–5,2 g/dL)	3,66	4,42	4,3	Indirect Coombs’ test	+++	++	−
MCV; (79–98 fl)	120,6	92,2	89	Total bilirubin; (0–1,1 mg/dL)	3,12	0,55	0,5	Lac test; (0,8–1,2)	1,98	2,42	2,55
RBC; (3,8–5,4 × 10^6/𝜇L)	1,45	4,75	4,8	Direct bilirubin; (0,01–0,2 mg/dL)	0,6	0,1	0,1	C4; (10–40 mg/dl)	<1,4	<1,4	8
RET; (20–160 × 10^3/μL)	346	102	86	AST; (0–31 IU/L)	26	18	18	AMA^1	1/320	1/160	1/160
PLT; (140–440 × 10^3/𝜇L)	401	245	238	ALT; (0–34 IU/L)	5	12	36	Anti-M2 IgG^2	30	25	<20
ESR; (0–20 mm)	105	43	20	𝜸–GT; (0–38 IU/L)	40	54	176	Anti-M2 IgA^3	502	304	<20
PT; (9–14 sec)	17,5	70,5	25	ALP; (0–120 IU/L)	80	110	137	Anti-CL IgM^4	>130	>100	94
INR; (0,85–1,15)	1,68	4,9	1,8	CPK; (0–145 U/L)	32	23	10	Anti-CL IgG^5	30^6	28^6	35^6
aPTT; (25–35 sec)	77,1	77,5	99,6	LDH; (0–247 IU/L)	603	165	123	Anti- 𝜷𝟐 -GPI IgM^6	179	62	40
Fibrogen; (180–440 md/dL)	309	271	256	CRP; (0,5 mg/dL)	0,6	0,3	0,3	Anti-𝜷𝟐 -GPI IgG^7	<20	<20	<20

WBC: white blood cells, NE: neutrophils, LY: lymphocytes, HCT: hematocrit, HGB: hemoglobulin, MCV: mean corpuscular volume, RBC: red blood cells, RET: reticulocytes, PLT: platelets, ESR: erythrocyte sedimentation rate, PT: prothrombin time, INR: international normalised ratio, aPTT: activated partial thromboplastin time, AST: aspartate transaminase, ALT: alanine transaminase, 𝛾-GT: gamma-glutamyl transpeptidase, ALP: alkaline phosphatase, CPK: creatine phosphokinase, LDH: lactate dehydrogenase, CRP: C-reactive protein, Lac test: lupus anticoagulant test The rests abbreviations are same as in text; Parentheses show the normal range; 1indirect immunofluorescence (IIF), on in-house rat multiorgan substrate panel that include-kidney, liver, and stomach tissue. Positive titer >1/20; 2,3M2-specific AMA by ELISA (Quanta Lite, INOVA Diagnostics, San Diego, Calif, USA); IgG-isotype AMA cut-off: 20 units; IgA-isotype AMA cut off: 217 optical density (OD).
4,5,6,7ELISAs (Quanta Lite, INOVA Diagnostics, San Diego, Calif, USA); cut-off of each ELISA: 20 units.