Gamma globulins

Gamma globulins 

Increased in immunoglobulins are often referred to as hyper gammaglobulinemia or gammopathies 

Hypogammaglobulinemia

This most often results from  decreased synthesis , but could also be associated with increased loss . 

1 - Decreased synthesis ( High A : G ratio ) 

a- failure of passive transfer or colostrum deprivation 

b - Combined immunodeficiency disease ( Both T & B cells are deficient ) 

c - Agammaglobulinemia 

d - Acquired deficiency associated with inflammation , immunosuppressive drugs or neoplasia 

2 - Increased loss : ( Normal A : G ratio ) 

Can occur in conjunction with albumin loss in hemorrhage , Protein- losing enteropathy , or exudative skin disease 

Increased Gamma Globulin (Gammopathies ) : 

Categorized based on the SPE profile : 

- Monoclonal Gammopathy : A single clone of B cells produces a single class of immunoglobulins or paraprotein . The electrophoretic peak or (spike) ( beta or gamma region ) Should be as sharp as , or sharper than , the albumin peak . 

- Polyclonal Gammopathy : Multiple , heterogenous B cell clones are involved , producing a broad - based increase in gamma globulins . Multiple immunoglobulin classes are increased , although ine class often predominates . 

Polyclonal Gammopathies ( causes ) : These gammopathies are usually induced by chronic antigenic stimulation . This may be the result of infectious , inflammatory or neoplastic disease .

1 - some chronic infections  associated with polyclonal gammopathy include : 

a - Dirofilariasis

b - Coccidiomucosis and other deep mycotic infections 

c - Infectious peritonites 

d - Chronic deep pyoderma 

e - Granulomatous diseases 

2 - Chronic inflammatory diseases induced polyclonal gammopathies :

a - immune-mediated diseases , including immune-mediated hemolytic anemia , systemic lupus erythematosus , rheumatoid arthritis , and autoimmune skin diseases . 

b - Liver disease 

c - Eosinophilic  myositis 

3 - Neoplastic disease can cause a polyclonal gammopathy by chronic exposure to tumor antigens . Lymphosarcoma can cause a polyclonal  or monoclonal  gammopathy , depending on the clones of cells that are neoplastic . ( Polyclonal gammopathy is more commonly seen .

Monoclonal Gammopathies ( causes ) 

1 - Plasma cell myeloma ( multiple myeloma ) is caused by a neoplastic proliferation of plasma cells , usually resulting in the overproduction of IgG  or IgA .  

Electrophoretogram : Plasma cell myeloma ( biclonal ) A : G = 0.32

2 - Other Causes of Monoclonal Gammopathies 

a - Lymphoma : A small percentage of lymphoma will exhibit a monoclonal gammopathy  . The  monoclonal spike is typically IgM . Polyclonal  gammopathy  is more commonly seen with lymphoma . 

b - Benign Monoclonal Gammopathy : It is characterized by the presence of a high concentration of homogeneous immunoglobulin  .