Immunoelectrophoretic ‘Tailing’ of Albumin Line Due to Albumin‐IgG Antibody Complexes: A Side Effect of Nitrofurantoin Treatment?

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Abstract
The immunochemical analysis of sera of 10 patients in which immunoelectrophoresis showed a cathodic, elongated,‘tailing’ albumin (TA) line is described. Eight of the 10 patients had been treated with nitrofurantoin, and withdrawal of the drug was followed by disappearance of the phenomenon in 5 cases. Most of the patients had polyclonally elevated IgG and IgA levels and a decreased albumin level; IgM, C3, C4, and C1-INH were normal. Antinuclear activity of IgG type was demonstrated in the sera of 9 patients. The TA phenomenon was due to noncovalently bound complexes between IgG and albumin. The combining sites of the IgG molecules were in the Fab fragment. The antibody-like activity of the IgG was directed towards autologous and isologous albumin. The anti-albumin activity remained unchanged after absorption of the antinuclear activity. The nitrofurantoin-induced albumin-anti-albumin system may prove useful as a human model of autoimmune response of known aetiology.