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 .