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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

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Item Value
Available Stat? No
Test code IGA, IGG, IGM
Performed by? Chemistry
Sendout? no
Price range $$
In House Availability 3 days per week
Principle Rate immunonephelometry.
Interpretation IgA, Clinical Significance:
a. Decreases in only IgA: One out of 600 patients congenitally lacks IgA, subjecting them to severe anaphylactic reactions following blood transfusions. Decreases occur with hereditary telangiectasia (4 of 5), Type III dysgammaglobulinemia, occasionally in malabsorption, SLE, cirrhosis, Still's disease, or recurrent otitis media. Although IgA deficiency may predispose to respiratory tract infections and tooth decay, many persons without IgA lack disease.

b. Generalized decreases in IgA, as well as the other immunoÂglobulins, occur in agammaglobulinemia (congenital, acquired), and thymic aplasia.

c. Increases in only IgA occur with IgA myeloma, cirrhosis of the liver, high-titered rheumatoid arthritis, and Wiskott-Aldrich Syndrome; occasionally in SLE or sarcoid.

IgG, Clinical Significance:
a. Increased: Chronic infection, lupus erythematosus, Down's syndrome after 10 years, hepatitis, Laennec's cirrhosis, rheumatoid arthritis, pulmonary tuberculosis, scleroderma, osteomyelitis, benign monoclonal gammopathy < 2000 mg/dL (< 20.0 g/L) or multiple myeloma, IgG type.

b. Decreased: Lymphoid aplasia, agammaglobulinemia, transient hypogammaglobulinemia of infancy, agammaglobulinemia with thymoma, Swiss-type agammaglobulinemia and immunosuppression due to drugs or malignant monoclone of another class.

IgM, Clinical Significance:
a. Increased IgM occurs in primary Waldenstrom's macroglobulinemia, but may also occur with neoplasms, collagen diseases, cirrhosis, arthritis, Raynaud's syndrome, cryoglobulinemia, amyloidosis, and chronic infections. Constitutes 9% of myelomas.

b. Selective decrease Wiskott Aldrich syndrome.

c. Decreased Along with other immunoglobulins, in immunologic deficiency syndrome.

Container type gold top gel tube
Amount to Collect 1 mL
Collection Instructions For newborn IgM, submit at least 2 mL cord blood.
Sample type Blood
Special instructions IgA, IgG, and IgM quantitations will be performed when protein electrophoresis (PEP) shows abnormalities in the immunoglobulin region, or as requested to follow immunologic disease.
Normal range
Age IgA IgG IgM
0-1 yr 0-100 273-1660 0-216
1-3 yr 24-121 533-1078 28-218
4-6 yr 33-235 593-1723 36-314
7-9 yr 41-368 673-1734 47-311
10-11 yr 64-246 821-1835 46-268
12-13 yr 70-432 893-1823 52-357
14-15 yr 57-300 842-2013 23-281
16-18 yr 74-419 646 -1864 35-387
>18 yr 50-386 605-1536 48-325

All units in mg/dL.
Synonyms IgA;IgG;IgM;
Stability 72 hrs at 2-8°C.
Additional information IgA, Indications: Investigation of any clonal gammopathy, ataxia telangiectasia, Wiskott-Aldrich syndrome, suspected isolated IgA deficiency and severe combined immunodeficiency and to monitor IgA monoclonal gammopathy.

IgG, Indications: Investigation of any clonal gammopathy or any immune deficiency. To monitor IgG monoclonal gammopathies and occasional autoimmune disease. Monitor therapy of multiple myeloma. IgG crosses the placenta to confer passive immunity to the newborn, but it can also cause hemolytic disease of the newborn. CSF IgG levels may be increased in multiple sclerosis, neurosyphilis, encephalitis and secondary to elevated serum IgG.

IgM, Indications: To investigate any clonal gammopathy or any immune deficiency. Detection of intrauterine infections (cord or newborn blood).
References 1. Beckman Immage Chemistry Information Manual 962248 February 1997. Beckman Coulter, Inc. Fullerton, CA.

2. Jolliff, C.R. et al.: Reference intervals for serum IgG, IgA, IgM, C3, and C4 as determined by rate nephelometry. Clin Chem, 28:126, 1982.

3. Tietz, N., ed., Fundamentals of Clinical Chemistry, 5th ed., Philadelphia: W.B. Saunders Co., p. 336-339, 2001.

4. Soldin, SJ, et al. Pediatric Reference Ranges 3rd ed. AACC Press 1999. Washington DC, 20037. Pg. 112-116.

CPT coding 82784
Last Updated 10/22/2012 6:28:31 PM
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