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Immunoglobulins (IgA, IgG, and IgM)
MessagePerforming Lab: Central Lab
Test Code
0514
Alias/See Also
Sunquest: IMMU
CPT Codes
82784
Includes
IGG; IGA; IGM
Preferred Specimen
0.6 mL Lithium Heparin Plasma (light green-top) tube
Minimum Volume
0.3 mL
Other Acceptable Specimens
Serum separator (gold-top), Red, Red/Gray
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated: 7 days
Methodology
Immunoturbidimetric
Setup Schedule
Monday - Friday
Report Available
Same day
Reference Range
IgA:
= 18 Years: 70 - 400 mg/dL
13-18 Years: 40 - 350 mg/dL
9-12 Years: 45 - 250 mg/dL
6-8 Years: 35 - 200 mg/dL
4-5 Years: 25 - 160 mg/dL
2-3 Years: 0 - 150 mg/dL
1 Year: 0 - 110 mg/dL
10-12 Months: 0 - 90 mg/dL
2-9 Months: 0 - 80 mg/dL
0-1 Month: 0 - 50 mg/dL
IgG:
=18 Years: 700 - 1600 mg/dL
7-18 Years: 650 - 1600 mg/dL
4-6 Years: 460 - 1240 mg/dL
2-3 Years: 420 - 1200 mg/dL
1 Year: 340 - 1200 mg/dL
10-12 Months: 290 - 1070 mg/dL
6-9 Months: 220 - 900 mg/dL
2-5 Months: 200 - 700 mg/dL
0-1 Month: 250 - 900 mg/dL
IgM:
=18 Years: 40 - 230 mg/dL
13 - 18 Years: 50 - 300 mg/dL
9 - 12 Years: 50 - 250 mg/dL
1 - 8 Years: 45 - 200 mg/dL
10 - 12 Months: 40 - 150 mg/dL
6 - 9 Months: 35 - 125 mg/dL
2 - 5 Months: 25 - 100 mg/dL
0 - 1 Month: 20 - 80 mg/dL
= 18 Years: 70 - 400 mg/dL
13-18 Years: 40 - 350 mg/dL
9-12 Years: 45 - 250 mg/dL
6-8 Years: 35 - 200 mg/dL
4-5 Years: 25 - 160 mg/dL
2-3 Years: 0 - 150 mg/dL
1 Year: 0 - 110 mg/dL
10-12 Months: 0 - 90 mg/dL
2-9 Months: 0 - 80 mg/dL
0-1 Month: 0 - 50 mg/dL
IgG:
=18 Years: 700 - 1600 mg/dL
7-18 Years: 650 - 1600 mg/dL
4-6 Years: 460 - 1240 mg/dL
2-3 Years: 420 - 1200 mg/dL
1 Year: 340 - 1200 mg/dL
10-12 Months: 290 - 1070 mg/dL
6-9 Months: 220 - 900 mg/dL
2-5 Months: 200 - 700 mg/dL
0-1 Month: 250 - 900 mg/dL
IgM:
=18 Years: 40 - 230 mg/dL
13 - 18 Years: 50 - 300 mg/dL
9 - 12 Years: 50 - 250 mg/dL
1 - 8 Years: 45 - 200 mg/dL
10 - 12 Months: 40 - 150 mg/dL
6 - 9 Months: 35 - 125 mg/dL
2 - 5 Months: 25 - 100 mg/dL
0 - 1 Month: 20 - 80 mg/dL
Clinical Significance
IgA represents 10 to 15% of serum immunoglobulin. Despite the uncertainty of its exact role in serum, its part in resistance against infection is due to the prevention of adherence of bacteria, or to the inhibition of attachment and penetration of viruses. IgA may be elevated in recurrent infections and anaphylactic transfusion reactions. Increases are also associated with chronic liver disease, chronic infections, neoplasia of the lower GI tract and inflammatory bowel disease. IgA may be used as an aid in the diagnosis of ataxia telangiectasia, in the differentiation of M-components in multiple myeloma, and in the evaluation of progression of IgA myeloma. Decreased levels of IgA may be found in isolated genetic deficiency, combined immunodeficiency disorders, non-IgA multiple myeloma or macroglobulinemia.
IgG is present in all extracellular fluids and accounts for 70 to 75% of the plasma immunoglobulins in adults. IgG functions to protect tissue spaces by eliminating small soluble proteins such as bacterial toxins and enhancing their clearance through the reticuloendothelial system. IgG levels may be elevated in recurrent or chronic infection, autoimmune diseases, and malignancies. Increased levels may also be observed in systemic lupus erythematosus, rheumatoid arthritis, some parasitic diseases, and infections. The most common form of multiple myeloma is the IgG type. Deficiency of IgG may be genetic (e.g., Wiskott-Aldrich syndrome, severe combined immunodeficiency) or acquired (e.g., AIDS).
IgM is the first immunoglobulin synthesized in response to antigenic challenge and accounts for 5 to 10% of the total circulating immunoglobulins. The role of IgM in activating the complement cascade and promoting phagocytosis makes it an important factor in eliminating particulate antigens and microorganisms from the circulation. IgM levels are used to evaluate monoclonal proteins seen on serum electrophoresis, and to monitor the progression or therapeutic response of patients with macroglobulinemia. Levels are frequently increased in viral infections, rheumatoid arthritis, and chronic hepatocellular disease, active sarcoidosis, Waldenström’s macroglobulinemia, and malignant lymphoma. Decreased levels are seen in association with recurrent, chronic, or severe infections, multiple myeloma (IgA or IgG), and protein-losing enteropathy (but not nephritic syndrome).
IgG is present in all extracellular fluids and accounts for 70 to 75% of the plasma immunoglobulins in adults. IgG functions to protect tissue spaces by eliminating small soluble proteins such as bacterial toxins and enhancing their clearance through the reticuloendothelial system. IgG levels may be elevated in recurrent or chronic infection, autoimmune diseases, and malignancies. Increased levels may also be observed in systemic lupus erythematosus, rheumatoid arthritis, some parasitic diseases, and infections. The most common form of multiple myeloma is the IgG type. Deficiency of IgG may be genetic (e.g., Wiskott-Aldrich syndrome, severe combined immunodeficiency) or acquired (e.g., AIDS).
IgM is the first immunoglobulin synthesized in response to antigenic challenge and accounts for 5 to 10% of the total circulating immunoglobulins. The role of IgM in activating the complement cascade and promoting phagocytosis makes it an important factor in eliminating particulate antigens and microorganisms from the circulation. IgM levels are used to evaluate monoclonal proteins seen on serum electrophoresis, and to monitor the progression or therapeutic response of patients with macroglobulinemia. Levels are frequently increased in viral infections, rheumatoid arthritis, and chronic hepatocellular disease, active sarcoidosis, Waldenström’s macroglobulinemia, and malignant lymphoma. Decreased levels are seen in association with recurrent, chronic, or severe infections, multiple myeloma (IgA or IgG), and protein-losing enteropathy (but not nephritic syndrome).
