✅ Polyclonal gammopathy (PG) is a type of hypergammaglobulinemia that results from an increased production of several different immunoglobulins by plasma cells.
✅ PG is most commonly associated with liver disease, acute or chronic inflammation, autoimmune disorders and certain malignancies.
✅ PG is generally considered a benign condition that does not progress to overt malignancy.
✅ PG may provide an important clue for less common difficult-to-diagnose conditions, such as eosinophilic granulomatosis with polyangiitis, IgG4-related disease, and Rosai–Dorfman disease.
✅ PG is part of the diagnostic criteria for rare diseases such as Idiopathic multicentric Castleman disease and Autoimmune lymphoproliferative syndrome (APLS).
✅ PG is diagnosed by serum protein electrophoresis and immunofixation electrophoresis (SPEP/IFE) showing a polyclonal increase in immunoglobulins (having 1 or more heavy-chain classes and both kappa and lambda light-chain types).
✅ Work up should focus on eight causes (“buckets”) of polyclonal hypergammaglobulinemia:
- Liver disease
- Autoimmune disease and vasculitis
- Infection and inflammation
- IgG4-related disease
- Hematological disorders
- Non-hematological malignancy
✅ Treatment includes treating the underlying disease/cause and plasma exchange in VERY rare cases in which polyclonal hyperglobulinemia results in hyperviscosity.