Hypogammaglobulinaemia may be:
- Usually diagnosed in infancy and managed by Paediatrics/ Immunologists.
- Excessive loss of immunoglobulin ( protein losing enteropathy, nephrotic syndrome, severe burns)
- Drug induced (chemotherapy, corticosteroids, immunosuppressants)
- Malignancy- CLL, myeloma ( light chain), lymphoma, Good’s syndrome
Patients usually present with recurrent infections (especially upper and lower respiratory tract infections & GI infections). There is also an increased incidence of autoimmune and connective tissue disorders.
Consider U&E, LFTS, urine dipstick, serum electrophoresis/ urinary BJP
If hypogammaglobulinaemia is an incidental finding without obvious secondary cause, consider performing Free Serum Light Chains analysis and refer to the guidance on Myeloma.
Who to refer?
Refer to Haematology A&G if unexplained hypogammaglobulinaemia
Dr Richard Noble, Consultant Haematologist, RCHT
Dr Bridgitte Wesson, GP & Kernow RMS Haematology guideline lead
Review date: 05/08/2020
Next Review 05/08/2021