Page 1449 - Small Animal Internal Medicine, 6th Edition

CHAPTER 89 Hyperproteinemia 1421

alb α-1 and α-2 β-1 and β-2 Gamma BOX 89.1
VetBooks.ir Diseases Associated With Polyclonal Gammopathies in
Dogs and Cats
Infectious
• Chronic pyoderma
• Pyometra
• Chronic pneumonia
• Feline infectious peritonitis
A • Mycoplasmosis
• Bartonellosis
• Ehrlichiosis
• Anaplasmosis
• Leishmaniasis
• Chagas disease
• Babesiosis
• Systemic mycoses
Immune-Mediated Diseases
B
Neoplasia
• Lymphomas
• Mast cell tumors
• Necrotic or draining tumors

Note: Entries in boldface are common causes; entries in regular
typeface are uncommon causes.

C
BOX 89.2
FIG 89.1
(A) Normal canine or feline serum protein
electrophoretogram. (B) Electrophoretogram from a dog Diseases Associated With Monoclonal Gammopathies in
with multiple myeloma and a monoclonal gammopathy in Dogs and Cats
the β 2-γ region. Note the narrow spike approximately the
same width as the albumin band. (C) Electrophoretogram Multiple myeloma
from a cat with feline infectious peritonitis and a typical Chronic lymphocytic leukemia
polyclonal gammopathy. Note the α-2 spike (APRs) and the Lymphoma
broad-based β-γ spikes. “Idiopathic” monoclonal gammopathy
Ehrlichiosis
Leishmaniasis
Bartonellosis
are instructed to produce specific antibody molecules simul- Feline infectious peritonitis
taneously; that is, each clone is programmed to produce one Chronic inflammation
specific antibody type against a specific antigen. As a conse-
quence, immune stimulation leads to the appearance of a
polyclonal band in the β or γ region, or both. This polyclonal
band is broad-based and irregular and contains most of the erythematosus, immune polyarthritis); and some neoplastic
Igs and complement generated by the immune cells. A typical diseases, although these are rare (Box 89.1). Polyclonal gam-
inflammatory-infectious electrophoretogram therefore con- mopathies are also common in otherwise healthy old cats.
sists of a normal to mildly decreased albumin concentration Monoclonal gammopathies occur when one clone of
and hyperglobulinemia resulting from increased concentra- immune cells produces the same type and subtype of Ig
tions of α 2 -globulins (i.e., APR) and β-γ globulins (poly- molecule. Because these molecules are identical, they migrate
clonal gammopathy; see Fig. 89.1, C). in a narrow band (monoclonal spike, or M component),
Typical inflammatory-infectious electrophoretograms located typically in the β or γ region (see Fig. 89.1, B). Mono-
are seen in several common disorders, including chronic clonal gammopathies occur in dogs with multiple myeloma,
pyoderma, pyometra, and other chronic suppurative chronic lymphocytic leukemia, or lymphoma (the latter
processes; feline infectious peritonitis (FIP); feline and infrequently). They are also occasionally present in dogs with
canine mycoplasmosis and other hemoparasite infec- ehrlichiosis or leishmaniasis; recently, a monoclonal gam-
tions; canine ehrlichiosis, anaplasmosis, and leishmaniasis; mopathy associated with Bartonella henselae infection was
chronic immune-mediated disorders (e.g., systemic lupus reported in a dog (Tabar et al., 2011) (Box 89.2). In cats