THE DYSGAMMAGLOBULINEMIC SYNDROME

Abstract

Four male patients were found to have discrete serum gamma-globulin electrophoretic peaks without other evidence of myeloma. Three of these patients were clinically similar to agamma globulinemic patients in that they were unusually susceptible to infections, particularly pneumococcal infections. Gel diffusion studies utilizing the Ouchterlony technique revealed that 3 of the proteins resembled myeloma proteins and 1 resembled macroglobulin. Ultracentrifuge studies revealed no increase in macroglobulins except for that protein reacting as a macroglobulin in gel diffusion studies. In this case the macroglobulin constituted 4.3% of the total protein whereas the abnormal electrophoretic peak made up 16% of the total protein. Multiple X-ray surveys of the bones as well as bone marrow aspirations have not revealed myeloma in these patients. After following for as long as 3 1/2 years it is suggested that these patients may represent a clinical syndrome different from that of myeloma or macroglobulinemia. Treatment has been symptomatic although 1 patient has seemed to have fewer infections with injections of gamma globulin.