Differential Diagnosis of Marked Hypergammaglobulinemia

 

Infectious conditions:

(1) chronic parasite infections (malaria, leishmaniasis, etc)

(2) chronic bacterial infections (endocarditis, osteomyelitis, etc)

(3) HIV infection

(4) chronic viral hepatitis

 

Noninfectious inflammatory conditions:

(1) sarcoidosis

(2) Sjogren’s disease

(3) systemic lupus erythematosus (SLE)

(4) chronic liver disease (primary biliary cirrhosis, autoimmune hepatitis, cirrhosis)

 

Other:

(1) lymphoproliferative disorders (Casteleman’s disease, myeloma, Waldenstrom’s macroglobulinemia)

 

Serum protein electropheresis and immunoelectropheresis may be necessary to separate monoclonal from polyclonal increases in gamma globulins.