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Cigarette smoking and chronic polyclonal B-cell lymphocytosis
A Delannoy1, D Djian, G Wallef
1Service de Médecine Interne, Hôpital de Jolimont, Haine-Saint-Paul, Belgium.
Nouvelle Revue Francaise D'Hematologie
|April 1, 1993
Summary
This study identifies a rare B-cell syndrome in women, characterized by specific blood cell changes and elevated IgM. Early recognition of lymphocyte morphology is crucial for diagnosis, even with normal counts.
Area of Science:
- Immunology
- Hematology
- Clinical Medicine
Background:
- A specific syndrome involving polyclonal B-cell increase and binucleate lymphocytes in smokers has been documented.
- This condition often presents with elevated serum IgM, splenomegaly, and lymphadenopathy in women.
- Many affected individuals are HLA-DR7 positive, and the condition typically shows a stable clinical course.
Purpose of the Study:
- To report four new cases of this rare B-cell syndrome.
- To investigate the polyclonal nature of lymphocytosis using DNA analysis.
- To highlight the importance of lymphocyte morphology in diagnosis.
Main Methods:
- Clinical case reporting of four patients.
- Peripheral blood smear analysis for lymphocyte morphology.
- DNA analysis to confirm polyclonal lymphocytosis.
- Serum IgM level assessment.
Main Results:
- All four patients exhibited features consistent with the described syndrome.
- DNA analysis confirmed polyclonal lymphocytosis in all cases.
- One patient presented with normal total lymphocyte count but characteristic morphology, underscoring diagnostic challenges.
Conclusions:
- The syndrome is characterized by polyclonal B-cell lymphocytosis and elevated IgM, often seen in female smokers.
- DNA analysis confirms the polyclonal nature of the lymphocyte increase.
- Careful examination of lymphocyte morphology is essential for diagnosing this syndrome, as normal lymphocyte counts can mask its presence.