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Cells in Blood

• Streptococcal infections

• Epstein-Barr virus

• Tuberculosis

• Collagen vascular disease

• Streptococcal infections

• Epstein-Barr virus

• Tuberculosis

• Collagen vascular disease

Adapted from Glassy E. Color Atlas of Hematology: An Illustrated Guide Based on Proficiency Testing. Northfield, IL: College of American Pathologists, 1998.

note is the color of the cytoplasm, which is a distinct sea blue or cornflower color. The chromatin, although clumped, is evenly arranged in a pinwheel structure. Plasma cells make immunoglobulins, the basic building blocks of antibody production (see Fig. 13.5). There are five types of immunoglobulin—IgG, IgM, Ig D, IgE, and IgA. Each immunoglobulin has:

• Four polypeptide chains

There are five different types of H chains

• Gamma (7), alpha (a), mu (p), epsilon (e), and delta (8)

There are two different types of L chains

Table 13.4 presents the specific function of each immunoglobulin type.

Table 13.4 O Immunoglobulin and Range of Activity

Immunoglobulin Range of Activity

IgG Secondary immune response, pre cipitating antibodies, hemolysins, virus neutralizing antibodies

IgA Secretory antibody, protects airways and gastrointestinal tract

IgM Primary immune response

IgD Lymphocyte activator and sup pressor

IgE Antibody found in respiratory and gastrointestinal tract/parasitic infections

210 Part III • White Cell Disorders

Figure 13.6 Serum protein electrophoresis showing patterns of (4) normal serum and (B) serum from patient with multiple myeloma; note the monoclonal spike in the gamma region.

210 Part III • White Cell Disorders

Figure 13.6 Serum protein electrophoresis showing patterns of (4) normal serum and (B) serum from patient with multiple myeloma; note the monoclonal spike in the gamma region.

Immunoglobulins are assessed either quantitatively or qualitatively Serum protein electrophoresis gives a representation of all serum proteins: immuno-globulins, albumins, and some minor proteins (Fig. 13.6). Immunoelectrophoresis, on the other hand, separates the specific immunoglobulins by using antibodies directed against each fraction combined with an electrical field and a gel medium.

Multiple Myeloma

One of the premier disorders of plasma cells (Fig. 13.7) is multiple myeloma. This disorder has a well-defined pathophysiology that centers around the accumulation of plasma cells in the bone marrow and other locations. Multiple myeloma occurs in older age, among men more than among women, and with greater frequency in the African American population.

Several environmental and occupational factors are thought to contribute to the clonal proliferation of c |

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