Multiple Heavy-Chain Determinants on Individual B Lymphocytes in the Peripheral Blood of Patients with Sjögren's Syndrome

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Abstract
Surface markers on peripheral blood lymphocytes were studied in Sjögren's syndrome. Cells bearing IgG, IgA, IgM and IgD were identified with monospecific fluorescent antiserums. In five of seven patients the frequency of cells identified with at least two anti-heavy-chain reagents was elevated. In two of these patients striking elevations were seen in the frequency of lymphocytes bearing each of the heavy-chain classes, the sum of the number of cells binding individual anti-heavy-chain serums being about four times greater than the apparent number of B lymphocytes as identified both with an anti-Fab reagent and by the binding of aggregated γ-globulin. The cells binding anti-heavy-chain serums were identified as B lymphocytes by doubling labeling procedures. These data indicate that individual B lymphocytes in some patients with Sjögren's syndrome bear multiple classes of heavy chains, an abnormality that has been noted by others in some patients with lymphoma. This association is of interest since there is a spectrum of benign to malignant lymphoproliferation in Sjögren's syndrome. (N Engl J Med 289:823–827, 1973)