Autoimmunity in Waldenstrom's macroglobulinaemia

Fifty-seven consecutive patients with Waldenstrom's Macroglobuliemia were s tudied retrospectively for autoimmune manifestations. 28 patients or 51% (1 6 women and 13 men) had clinical and/or serological autoimmune manifestatio ns, two or more of these being concomitant in 20 (12 women and 8 men). The predominant findings were Coombs' positive autoimmune hemolytic anemia (16% ), seropositive rheumatoid arthritis (16%), inflammatory gastric ulcer with parietal cell autoantibodies (12%), and IgM-cardiolipin syndrome (11%). 40 % of the autoimmune manifestations were present at the time of diagnosis of the Waldenstrom's Macroglobulinaemia and 60% were observed over a mean per iod of 4.7 years. All patients had an IgM M-component. There was no correla tion between autoimmunity and the size of the M-component or the degree of hypo-IgG and hypo-IgA gammaglobulinemia. The only correlation between autoi mmunity and infection was found in patients with gastric ulcer and parietal cell autoantibodies, in whom the infection was caused by Helicobacter pylo ri.