Hypogammaglobulonemia is a decrease in the level of gamma-globulins or immunoglobulins, substances having an important role in the immune system. This biological anomaly can be due to the taking of certain drugs or to various pathologies, some of which require a rapid diagnosis. 

Hypogammaglobulinemia is defined by a gamma-globulin level of less than 6 g / l on plasma protein electrophoresis (EPP). 

Gamma globulins, also called immunoglobulins, are substances made by blood cells. They have a very important role in the body’s defenses. Hypogammaglobumonemia leads to a more or less severe reduction in immune defenses. It is rare.

The examination that allows for a determination of gamma-globulins, among other things, is the electrophoresis of serum proteins or plasma proteins.It is carried out in case of suspicion of certain diseases or following abnormal results during the first examinations. 

This examination is prescribed in case of suspicion of a humoral immune deficiency in the presence of repeated infections, especially of the ENT and bronchopulmonary sphere or of deterioration of the general condition, in case of suspicion of multiple myeloma ( symptoms: bone pain, anemia, frequent infections…). 

This test can also be used following abnormal results showing an increase or decrease in serum protein, high urine protein, high blood calcium, an abnormality in the number of red blood cells or white blood cells.

The electrophoresis of serum proteins is the examination which makes it possible to measure the gamma globulins. 

This routine biology test (blood sample, usually from the elbow) allows the quantitative approach of the various protein components of the serum (albumin, alpha1 and alpha2 globulins, beta1 and beta2 globulins, gamma globulin). 

The electrophoresis of serum proteins is a simple examination which makes it possible to detect and participate in the monitoring of numerous pathologies: inflammatory syndromes, certain cancers, physiological or nutritional disorders.

It directs towards the necessary additional examinations (immunofixation and / or specific assays of proteins, haematological assessment, renal or digestive exploration).

The discovery of hypogammaglobulonemia may be due to the taking of drugs (oral corticosteroid therapy, immunosuppressants, anti-epileptics, tumor chemotherapy, etc.) or to various pathologies. 

Additional examinations allow a diagnosis to be made when the drug cause is ruled out. 

To detect pathologies which are diagnostic emergencies (light chain myeloma, lymphoma, chronic myeloid leukemia), three examinations are carried out: the search for a tumor syndrome (lymphadenopathy, hepato-splenomegaly), the detection of proteinuria and a blood count.

Once these diagnostic emergencies have been ruled out other causes of hypogammaglobulonemia are mentioned: nephrotic syndrome, exudative enteropathies. The causes of exudative enteropathies can be chronic inflammatory bowel disease, celiac disease as well as solid digestive tumors or certain lymphoid hemopathies such as lymphoma or primary amyloidosis (LA, light chain amyloidosis of immunoglobulins).

More rarely, hypogammaglobulonemia may be caused by humoral immune deficiency.

Severe malnutrition or Cushing’s syndrome can also be the cause of hypogammaglobulonemia.

Additional examinations allow the diagnosis to be made (thoraco-abdominal-pelvic scanner, blood count, inflammatory workup, albuminemia, 24-hour proteinuria, weight determination of immunoglobulins and blood immunofixation)

Treatment depends on the cause. 

It can be set up a preventive treatment in people suffering from hypogammaglobulinemia: anti-pneumococcal vaccination and other vaccinations, antibiotic prophylaxis, substitution in polyvalent immunoglobulins.