Polyclonal gammopathy- so what?

What exactly does this mean for me? How can my immunoglobulins be up but my WBC is low? Does everyone with SS have poly G? Does it mea I’m “flaring”?

Depending on the type of SS you have the incidence of Poly G ranges from 20% - 50% Serological studies are more related to prognosis than diagnoses in SS. Monoclonal gammopathy has been associated with pulmonary disease, cryoglobulinemia and an increased risk of lymphoproliferative disease. You could be going extra glandular. or simply have non primary SS (which is the most likley.) Your doc can sort that out.

I didn't see what meds you were taking but the most common cause of increased immunoglobins to be up and a lower WBC is usually immonsuppresive medications. In which case the meds are working..................

I'll also warn you serological testing is almost never something to get worked up about. You need more than one abnormal test to determine a trend. There are two many variables. Time of day, other meds, hydration, what you had to eat (or didn't eat.) Its important to keep on top of things BUT I wouldn't recommend trying to follow serology too closely. It will drive you nuts and "Dr. Google" will have you making final arrangements with something as simple as hay fever.

My presenting symptoms were trigeminal neuropathy, Worst headache of my life, and fatigue. I saw a neurologist who ran the labs which showed SSA and B very high, poly G and leukopenia.

Retrospectively to add to the labs and TG, I have had Reynauds for many years. And I’ve had blocked salivary gland twice. And I sometimes get an exercised induced hive-like rash - not sure that’s anything significant.

Then I started gabapentin and took a steroid pack. My Headache resolved. Gabapentin has somewhat helped the TG pain. Neg MRI brain - whew! And then saw rheum who did some more labs and then said primary SS and put me on Plaquenil. I’ve been on it a month. I FEEL better. I can exercise again. But my TG is progressing.

Thank u, TJ for the info, any other info or advice u have is welcome. U are so right about DrGoogle and digging my grave. Really. I’m scared that if the antibodies/ immunoglobulins- whatever they are, continue on their eat-my-nerve campaign then what is next? F, you know?!?! Can we cuss on here ? because that would be wonderful. And what exactly are they doing to my nerve?

I read that people with primary SS have a normal life span and I try to remind myself of that. I just wish I could understand this disease better and do something to prevent progression.

I don't know about MGUS and Sjogren's disease. My husband has had MGUS for about 5 years, and it hasn't progressed to anything else. Same thing with a friend of ours. If you check out MGUS on the Mayo clinic site you will see that only about 2% of people with MGUS progress to something else in a year, although this is cumulative, that is the 2nd year is 4% and so on. When MGUS does progress it's to multiple myeloma or lymphoma, and these also occur in varying degrees of seriousness. It sounds to me, and I'm not a Dr., like most of your symptoms are from the Sjogren/s. Jaycee

Thanks Jaycee. Great news your husband is doing well. I think MGUS is a monoclonal spike. My labs show polyclonal Spike, I don't really understand it other than all the immunoglobulins are up. And monoclonal can sometimes progress to MM or lymphoma like you said. Thank you though!! :)

The most likely reason is the Plaquenil. FWIW the most COMMON cause of a spike is connective tissue disease. SS the leader. Read here:


Poly g present before Plaquenil.