Hepatosplenic alpha/beta T cell lymphoma presenting with cold agglutinin disease

Early Serologic Diagnosis of Mycoplasma pneumoniae Pneumonia: An Observational Study on Changes in Titers of Specific-IgM Antibodies and Cold Agglutinins

There have been some limitations on early diagnosis of Mycoplasma pneumoniae (MP) infection because of no immunoglobulin M (IgM) responses and variable detection rates of polymerase chain reaction in the early stage of the disease. We wanted to discuss regarding early diagnostic method using short-term paired titration of MP-specific IgM and cold agglutinins (CAs) in the early stage of MP pneumonia.The participants of this study were 418 children with MP pneumonia during 2 recent epidemics (2006-2007 and 2011), and they were diagnosed by an anti-MP IgM antibody test (Serodia Myco II) examined twice during hospitalization at presentation and around discharge (mean of 3.4 ± 1.3 days apart). CA titers were simultaneously examined twice during study period. Anti-MP IgM antibody titer ≥1:40 and CA titer ≥1:4 were considered positive, respectively. The relationships between 2 IgM antibodies in the early stage were evaluated.Regarding MP-specific antibody titers, 148 patients showed a seroconversion, 245 patients exhibited increased titers, and 25 patients had unchanged higher titers (≥1:640) during hospitalization. The median MP-specific antibody titers at each examination time were 1:80 and 1:640, respectively; those of CAs were 1:8 and 1:32, respectively. Illness duration prior to admission showed a trend of association with both titers, and patients with shorter illness duration had a higher rate of negative titers or lower titers at each examination time. CAs and MP-specific antibody titers were correlated in the total patients at presentation and at 2nd examination (P < 0.001, respectively), and the diagnostic corresponding rates of CAs to IgM antibody test were 81% to 96% in patient subgroups.Short-term paired MP specific-IgM determinations in the acute stage may be used as a definitive diagnostic method for MP pneumonia. Paired CA titers showed a correlation with MP-specific antibody titers, suggesting they can be used as an adjuvant diagnostic method.

Mutation of inhibitory helix-loop-helix protein Id3 causes γδ T-cell lymphoma in mice

Human γδ T-cell lymphoma is a rare clinicopathologic entity with aggressive course and poor prognosis. The etiology and pathogenesis of γδ T-cell lymphoma is unknown. We show here that mice with deficiency in inhibitory helix-loop-helix protein Id3 (Id3(-/-)) developed γδ T-cell lymphoma that resembled human γδ T-cell lymphoma. The Id3(-/-) mice with lymphoma showed splenomegaly, hepatomegaly, and lymphadenopathy with involvement of bone marrow, thymus, kidney, and lungs between 6 and 15 months of age. Phenotypic analysis revealed that lymphomatous cells were cluster of differentiation (CD)3(+), γδ T-cell receptor (TCR)(+), and αβ TCR(-), and expressed CD8(+)CD4(-), CD4(+)CD8(-), or a mixture of the two. Id3(-/-) γδ T-cell lymphoma used predominantly Vγ1.1, some Vγ3, yet no Vγ2 TCR, and some showed increased levels of the oncogene c-Myc. Strikingly, adoptive transfer of the γδ T-cell lymphoma into syngeneic Rag1(-/-) mice resulted in aggressive γδ T-cell lymphoma, identical to the Id3(-/-) donor. Thus, our data demonstrate that Id3 regulates the development of γδ T-cell lymphoma in mice, raising a possibility of Id3 gene mutation in human γδ T-cell lymphoma. Our model will provide a tool for studying the molecular mechanisms and development of human γδ T-cell lymphoma.

Autoimmune hemolytic anemias, Evans' syndromes, and pure red cell aplasia in non-Hodgkin lymphomas

We analyzed 108 cases of non-CLL non-Hodgkin lymphoma (NHL) associated with autoimmune hemolytic anemia (AIHA) (+/- pure red cell aplasia (PRCA)) or Evans' syndrome. The analysis was based on cases reported in the literature, which were retrieved by means of Pubmed and Medline searches and of an original series of 121 patients with NHL as well as reference lists of papers in the field. The number of cases in various NHL subtypes was small (n = 6-25). Nevertheless, interesting and sometimes unexpected differences in sex prevalence, temporal relationship between onset of lymphoma and AIHA, stage of lymphoma, relative frequency of warm antibody-AIHA (WA-AIHA) and cold antibody (CA-AIHA), association with PRCA and response of AIHA to treatments were noted for various lymphoma entities. WA-AIHA was more frequent in B-cell lymphomas, while CA-AIHA and PRCA predominantly occurred in T-cell lymphomas. Anti-lymphoma treatment seemed to be more effective against AIHA than conventional therapy with steroids or immunoglobulin. Although generated by a literature survey, this compilation of data indicates a complex relation of lymphoma and AIHA and warrants more attention and specific studies.