Evidence map›Paper›PMID 41181767›Full record

ArticleCureus2025

Polyclonal Hypergammaglobulinemia Associated With Multimorbidity and Malnutrition in an Elderly Man: A Comprehensive Diagnostic Approach.

Keigo Hirasa, Junya Ohara, Ryuichi Ohta

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Keigo HirasaCommunity Care, Unnan City Hospital, Unnan, JPN.
Junya OharaFamily Medicine, Matsue Seikyo Hospital, Matsue, JPN.
Ryuichi OhtaCommunity Care, Unnan City Hospital, Unnan, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 76-year-old man with a history of liver cirrhosis, chronic obstructive pulmonary disease (COPD), secondary adrenal insufficiency, and psychiatric comorbidities presented with severe weight loss and laboratory findings of pancytopenia, hypoalbuminemia, and IgG-predominant hypergammaglobulinemia, raising suspicion for multiple myeloma. However, serum protein electrophoresis, immunofixation, and urinary Bence Jones testing showed no monoclonal protein, and the kappa/lambda (κ/λ) ratio remained normal, indicating polyclonal hypergammaglobulinemia. Further evaluation revealed decompensated liver cirrhosis with hypersplenism, secondary adrenal insufficiency, severe obstructive ventilatory defect from COPD, and nutritional deficiencies. Management included nutritional supplementation, infection control, diuretics, hydrocortisone replacement, and branched-chain amino acids, leading to gradual improvement and discharge with preserved daily function. This case illustrates how multimorbidity, malnutrition, and disuse can mimic malignant conditions, producing hypergammaglobulinemia and weight loss through chronic systemic inflammation. It emphasizes the importance of considering non-malignant causes, especially in frail older patients, and highlights the need for a comprehensive diagnostic and management approach that integrates chronic disease care, nutritional support, and community-based interprofessional collaboration.

Indexed as

adrenal insufficiencychronic obstructivefamily medicinefrailtygeneral medicinehypergammaglobulinemialiver cirrhosispolyclonal gammopathypulmonary diseaserural

Identifiers

PMID41181767
PMCPMC12578607

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.