EUGENE M. McKELVEY, M.D.; HAU C. KWAAN, M.D., F.A.C.P.
An acquired IgM type L inhibitor factor VIII was identified in a 63-year-old man who presented with a 2-year history of arthralgia and occasional Raynaud's phenomenon. The patient has shown no evidence of underlying malignancy, drug sensitivity, collagen disease, Waldenström's macroglobulinemia, or other overt dysproteinemia. The inhibitor was initially present in high titer (1:1200) and was not corrected in vitro with either porcine factor VIII or human cryoprecipitate. However, inhibitor activity was suppressed by specific antiserums to anti-human IgM and type L light polypeptide chains and by reduction and alkylation of the purified IgM antibody. Treatment with chlorambucil was accompanied by a reduction in the patient's serum anti-factor VIII activity.
McKELVEY EM, KWAAN HC. An IgM Circulating Anticoagulant with Factor VIII Inhibitory Activity. Ann Intern Med. ;77:571–575. doi: 10.7326/0003-4819-77-4-571
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Published: Ann Intern Med. 1972;77(4):571-575.
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