Immunoglobulin Light Chain Levels Can Be Used to Determine Disease Stage in Children with Juvenile Idiopathic Arthritis

Necil Kutukculer; Neslihan Edeer Karaca; Elif Azarsiz; Guzide Aksu; Nesrin Gulez

doi:10.29074/ascls.24.2.93

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Errata - April 01, 2012

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Necil Kutukculer, M.D.⇑
1. Ege University, School of Medicine, Division of Pediatric Immunology, Izmir, Turkey
Neslihan Edeer Karaca, M.D.
1. Ege University, School of Medicine, Division of Pediatric Immunology, Izmir, Turkey
Elif Azarsiz, M.D.
1. Ege University, School of Medicine, Division of Pediatric Immunology, Izmir, Turkey
Guzide Aksu, M.D.
1. Ege University, School of Medicine, Division of Pediatric Immunology, Izmir, Turkey
Nesrin Gulez, M.D.
1. Ege University, School of Medicine, Division of Pediatric Immunology, Izmir, Turkey

Address for Correspondence: Dr. Necil Kutukculer, Faculty of Medicine, Ege University, Department of Pediatrics, 35100 Bornova, Izmir, Turkey, Phone number: 0090 232 3901016, necil.kutukculer{at}ege.edu.tr

Abstract

OBJECTIVE: Patients with some inflammatory diseases have been shown to have increased levels of immunoglobulin light chains. In this study, we measured the concentrations of immunoglobulin kappa (κ) and lambda (λ) light chains in sera of patients with juvenile idiopathic arthritis (JIA) (study group), familial mediterranean fever (FMF) (disease control group) and in healthy children. Our aim was to compare immunoglobulin light chain levels with other well-known markers of inflammation, such as the erythrocyte sedimentation rate (ESR) and the acute phase reactants (APRs), serum amyloid A (SAA) and C-reactive protein (CRP), to find out if immunoglobulin light chain determinations have any discriminating value in the follow-up of these patients.

RESULTS: ESR, CRP, SAA, κ and λ chain levels and λ/IgG ratio showed a statistically significant difference between active and remission stages in JIA patients. κ correlated very well with SAA and ESR in both stages. On the other hand, λ correlated with SAA and ESR only in the remission period. There was no significant difference in κ and λ chain levels between active and remission stages in FMF patients. In addition, κ and λ chain concentrations showed no correlation with other markers of inflammation and immunoglobulin levels neither in entire FMF group nor in different subgroups with respect to clinical status. Immunoglobulin light chains κ and λ as well as levels of three markers of inflammation were found to be significantly higher in JIA patients who were in the active stage of disease when compared to data of healthy children

CONCLUSION: Ig light chains especially κ chain concentrations are helpful to determine disease stage in JIA patients but with our current data, they do not exhibit superiority to any of the classical tests for inflammation.

ABBREVIATIONS: ESR = erythrocyte sedimentation rate, APRs = acute phase reactants, CRP = C-reactive protein, SAA = serum amyloid-A, JIA = juvenile idiopathic arthritis, FMF = familial mediterranean fever, Ig = immunoglobulin, ILAR = International League of Associations for Rheumatology