Hypergammaglobulinemia: Definitions, Causes and Treatments

Verified on 06/20/2022 by PasseportSanté

Hypergammaglobulinemia is an increase in the blood of a type of antibody called gamma globulin. This is usually the consequence of an underlying disease. Therefore, the treatment of hypergammaglobulinemia will depend on the disease in question.

Here are all our explanations.

What is hypergammaglobulinemia?

To understand what hypergammaglobulinemia is, we must first look at gamma globulins.

gamma globulins

Gamma globulins are proteins found in blood plasma. They belong to the family of immunoglobulins, that is, antibodies, which are molecules of the immune system.

They are dosed (that is, we measure their amount in the blood) and analyzed in clinical practice using a laboratory technique called blood protein electrophoresis.

Normal gamma globulin level

The normal level of gamma globulins in the blood is between 6 and 12 g/L. They can be reduced in the case of immunodeficiency, and increased in the case of an inflammatory or infectious state, and cirrhosis. Gamma globulins can also be derived from donor blood plasma for therapeutic use in an immunocompromised person to help boost poor immunity.

High level of gamma globulin

Hypergammaglobulinemia consists of an increase in the serum concentration of gamma globulins above 18 g/L. This elevation is found during various inflammatory syndromes or proliferation of malignant plasma cells.

There are two types of hypergammaglobulinemia.

monoclonal hypergammaglobulinemia

It affects only one type of gamma globulin: it is found, for example, during Waldenström’s disease.

polyclonal hypergammaglobulinemia

These are various types of gamma globulins: it is found in other pathologies, such as rheumatoid arthritis, leukemia or even diabetes.

Low gamma globulin levels and hypogammaglobulinemia

It is also possible to have a gamma globulin level that is too low, that is, less than 5 g/L. This is called hypogammaglobulinemia.

The latter is usually the result of a nutritional deficiency, kidney disease in which the kidney passes too much protein into the urine, or intestinal disease such as Crohn’s disease or celiac disease.

What causes hypergammaglobulinemia?

The elevation of gamma globulins is due to a greater than normal stimulation of the B lymphocytes, that is, the white blood cells. This “overstimulation” of the white blood cells leads to an important secretion of antibodies and, therefore, of gamma globulins.

Hypergammaglobulinemia can be a consequence of various diseases or pathological conditions such as:

  • liver diseases: alcoholic cirrhosis, chronic hepatitis, post-hepatitis cirrhosis, etc. ;
  • a chronic bacterial infection (deep abscess, endocarditis, tuberculosis, dilated bronchi, etc.);
  • a parasitic infection;
  • viral infection, especially HIV;
  • an autoimmune disease, that is, a disease in which the immune system turns against the body;
  • tumor disease: lymphoma, leukemia;
  • other pathology.

What are the symptoms of hypergammaglobulinemia?

Hypergammaglobulinemia is usually asymptomatic, that is, the affected person has no symptoms.

When this is not the case, the clinical signs are not specific for hypergammaglobulinemia. In most cases, they are related to the pathology responsible for this increase in gamma globulins.

Because hypergammaglobulinemia is usually caused by a disease or medical condition, its treatment is usually to treat the underlying disease.

Indeed, in most cases, treatment of the associated disease leads to a resolution of immune dysregulation and a reduction in inflammation. This has the consequence of reducing the secretion, and therefore the blood level, of gamma globulins.

The first step towards the resolution of hypergammaglobulinemia is therefore a correct diagnosis of the pathological condition responsible for this increase in the level of gamma globulin. Once the diagnosis is made, the corresponding treatment can be established.

In many cases, corticosteroids will be part of the treatment and will help bring gamma globulin levels back to normal.

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