SECONDARY MIXED CRYOGLOBULINEMIA AMONG CHRONIC GINGINVITIS PATIENTS
Baha Hamdi Hakim Al-Amiedi
College of Dentistry, University of Babylon, Hilla, Iraq. e-mail : dent.bahai.hamdiy@uobabylon.edu.iq
(Received 27 March 2019, Revised 2 June 2019, Accepted 9 June 2019)

ABSTRACT : The separated cryoprotein from the sera of chronic gingivitis patients were colloid, opaque crystalline or gelatineous precipitates at 40C for one to five days. These precipitates were dissolved at 370C and precipitates at 40C. Such characters were consistant with cryoglobulin. The cryocrit percentages were ranged from 1-12% with mean value of 5.35%. The cryoglobulin concentrations were ranged between 90 and 230 mg/L with mean value of 225.7 mg/L. Ten out of 23 patients were rheumatoid factor positive 10:23 (43.8). Immunofixation studies using single radial immunodiffusion Behring partigen types were showing secondary mixed cryoglobulinemia of IgG-IgM-IgA type. Rheumatiod factor positive cases have shown high cryoglabulin isotype concentration than that of negative cases.
Key words : Cryoglobulin, isotype, rheumatoid factor, secondarcry globulinemia.






INTRODUCTION
The stomium is a reservoir for a variety of endogenous bacterial antigens and the port of entry for several exogenous bacterial antigens into the alimentary and respiratory systems. In normal state these antigens do not cause disease and swallowed away with saliva into the distant part of gat (Samaranayake and Jones, 2002).
This stomial compartment is supported by efficient elements like; mucous membrane, tonsils, salivary glands, gingiva and peridotium (Orga, 1999). Gingival microbial in infections mediate antigens that stimulate both mucosal and system immune responses with characteristic, IgM primary immune response then class switched to IgA or IgG (Paul, 2003).
Human serum have several protein subfractions as prealbumin, albumin, alpha, beta and gamma globulins. Gamma globulins harbor the immunoglobulin fraction. Immunoglobulin behave to temperature as; normoglobulin, cryglobulin and pyroglobulin. Among which cryglobulin is associated with lymphoproliferative disorder and chronic infectious diseases (Lynch, 2006; Delgado et al, 2008). Secondary mixed cryoglobulinemia has been documented in tonsillitis patients in this area (Jassim, 2015). Cryoglobulin has been successfully used for probing herd immunity in pediatric patients (Shnawa and Jassim, 2015). The objective of the present work was at reporting secondary mixed cryoglobulinemia among chronic gingivitis patients.

MATERIALS AND METHODS
During the period October 2016 to Arpril 2017 twenty three gingivitis patients attending college of Dentistry clinic were diagnosed by specialized dentist and were the study patients. Blood samples were drone from each patient and sera were saved (Stevens, 2010).
Protein concentration were determined for the cryoglobulin fractions by Biuretmethod (Lynch, 2006). Cryocrit % and immunofixation were done in accordance with Bishops et al (1988). Biometric analysis were made as in Steel et al (1997).
RESULTS
1. Cryoprotein
The separated cryoproteins from the patient sera were colloid, opaque, crystallin or gelatineous, precipitated at 40C within one to five days, dissolved at 370C and reprecipitated at 40C.
2. Cryocrit
The cryocrit percentages of chronic gengivitis patients were ranged from 1-12% with mean value of 5.35% (Table 1).
3. Cryoglobulin concentrations
The concentration range of cryoglobulin preparations were 90-230 mg/L with mean value of 225.7 mg/L (Table 2).