Retrospective cohort study of 148 patients with polyclonal gammopathy

Objective: To quantify clinical conditions and laboratory values associated with moderate to marked polyclonal gammopathy. Patients and Methods: Patient characteristics, laboratory correlates, evolv ing disease states, and survival of all patients seen at the Mayo Clinic, R ochester, 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 y ears; 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 m alignancies in 4 (3%). No difference in gamma globulin levels existed betwe en groups. With a median follow-up of 67 months, 90 (63%) of 143 patients f or 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 dis order. Conclusion: Moderate to marked polyclonal gammopathy may reflect an underly ing condition: liver disease, connective tissue disease, hematologic disord er, infection, or malignancy.