Causes of high total immunoglobulins (hypergammaglobulinemia) may include acute and chronic infections, connective tissue disorders, primary biliary cirrhosis, hematological disorders, cryoglobulinemia, non-hematological malignancies, and leukemias, lymphomas, and multiple myeloma.
When interpreting results in the presence of hypergammaglobulinemia, it is important to assess for variability in specific IgA/IgG results to determine if there is interference.
- If Total IgA/IgG are HIGH, and MOST/ALL specific IgA/IgG are HIGH, suspect interference
- If Total IgA/IgG are LOW, and MOST/ALL specific IgA/IgG are LOW, suspect interference
- If Total IgA/IgG are HIGH, and SOME specific IgA/IgG are NORMAL, some MODERATE, and some HIGH, this is likely a true antigen-antibody reaction
- If Total IgA/IgG are LOW, and SOME specific IgA/IgG are NORMAL, some MODERATE, and some HIGH, this is likely a true antigen-antibody reaction
The webinar titled "Challenges in Interpreting Antibody Based Tests" on Vibrant's Education Portal provides additional information and examples of test interpretation with hypo- and hypergammaglobulinemia.
