Retrospective cohort study of 148 patients with polyclonal gammopathy.
OBJECTIVE
To quantify clinical conditions and laboratory values associated with moderate to marked polyclonal gammopathy.


METHODS
Patient characteristics, laboratory correlates, evolving disease states, and survival of all patients seen at the Mayo Clinic, Rochester, Minn, during 1991 with a polyclonal gamma globulin level of 3.0 g/dL or higher were reviewed in this retrospective cohort study.


RESULTS
One hundred forty-eight patients were identified (median age, 58 years; 59% female). In 130 patients (88%), only 1 diagnosis was identified. Liver disease was the most common single disease association in 79 (61%) of 130 patients, followed by connective tissue diseases in 28 (22%), chronic infections in 8 (6%), hematologic disorders in 6 (5%), and nonhematologic malignancies in 4 (3%). No difference in gamma globulin levels existed between groups. With a median follow-up of 67 months, 90 (63%) of 143 patients for whom follow-up was available were alive. By multivariate analysis, age, albumin concentration, disease group, and platelet count were predictive of survival. No patient developed myeloma or a clonal plasmaproliferative disorder.


CONCLUSIONS
Moderate to marked polyclonal gammopathy may reflect an underlying condition: liver disease, connective tissue disease, hematologic disorder, infection, or malignancy.
Dispenzieri
A
A
Division of Hematology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Gertz
M A
MA
Therneau
T M
TM
Kyle
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003240:Connective Tissue Diseases / Q000150:complications; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000401:mortality; D008107:Liver Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies