Pregnancy in patients on maintenance dialysis is rare, with few cases of successful live births reported in Australian women on dialysis at the time of conception. Increasing dialysis delivery may improve outcomes for both mother and foetus in this high-risk situation. We report a case of successful pregnancy outcome with the application of an intensive dialysis regimen.
SUMMARY
The immunoglobulins synthesized by circulating lymphocytes were analysed in four cases of multiple myeloma and five cases of Waldenstrom's macroglobulimemia.
No evidence was found of peripheral lymphocytes synthesizing myeloma globulin in multiple myeloma. The data suggested that excessive amounts of macroglobulin were made by lymphocytes in four of the five cases of macroglobulinæmia.
Deficiencies in the synthesis of one or more immunoglobulins were seen in a number of these cases. It is therefore suggested that there are two types of abnormality in these conditions: firstly, synthesis of a particular immunoglobulin molecule by excessive numbers of cells, possibly malignant cells derived from a single mutant; secondly, a failure of recruitment of lymphocytes for the synthesis of normal immunoglobulins. The second abnormality may be explained by a failure of the mechanism of terminal immunological differentiation.
Pitfalls in the interpretation of autoradiographs of immunoelectrophoresis patterns are discussed.
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