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HelpTest ID: IMMG Immunoglobulins (IgG, IgA, and IgM), Serum
Reporting Name
Immunoglobulins IgG,A,M, SUseful For
Detecting or monitoring of monoclonal gammopathies and immune deficiencies
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 14 days |
Reference Values
IgG
0-<5 months: 100-334 mg/dL
5-<9 months: 164-588 mg/dL
9-<15 months: 246-904 mg/dL
15-<24 months: 313-1,170 mg/dL
2-<4 years: 295-1,156 mg/dL
4-<7 years: 386-1,470 mg/dL
7-<10 years: 462-1,682 mg/dL
10-<13 years: 503-1,719 mg/dL
13-<16 years: 509-1,580 mg/dL
16-<18 years: 487-1,327 mg/dL
≥18 years: 767-1,590 mg/dL
IgA
0-<5 months: 7-37 mg/dL
5-<9 months: 16-50 mg/dL
9-<15 months: 27-66 mg/dL
15-<24 months: 36-79 mg/dL
2-<4 years: 27-246 mg/dL
4-<7 years: 29-256 mg/dL
7-<10 years: 34-274 mg/dL
10-<13 years: 42-295 mg/dL
13-<16 years: 52-319 mg/dL
16-<18 years: 60-337 mg/dL
≥18 years: 61-356 mg/dL
IgM
0-<5 months: 26-122 mg/dL
5-<9 months: 32-132 mg/dL
9-<15 months: 40-143 mg/dL
15-<24 months: 46-152 mg/dL
2-<4 years: 37-184 mg/dL
4-<7 years: 37-224 mg/dL
7-<10 years: 38-251 mg/dL
10-<13 years: 41-255 mg/dL
13-<16 years: 45-244 mg/dL
16-<18 years: 49-201 mg/dL
≥18 years: 37-286 mg/dL
Day(s) Performed
Monday through Friday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
82784 x 3
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| IMMG | Immunoglobulins IgG,A,M, S | 34550-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| IGA | Immunoglobulin A (IgA), S | 2458-8 |
| IGM | Immunoglobulin M (IgM), S | 2472-9 |
| IGG | Immunoglobulin G (IgG), S | 2465-3 |
Clinical Information
The gamma globulin band as seen in conventional serum protein electrophoresis consists of 5 immunoglobulins. In normal serum, about 80% is IgG, 15% is IgA, 5% is IgM, 0.2% is IgD, and a trace is IgE.
Elevations of IgG, IgA, and IgM may be due to polyclonal immunoglobulin production.
Monoclonal gammopathies of all types may lead to a spike in the gamma globulin zone seen on serum protein electrophoresis. Monoclonal elevations of IgG, IgA, IgD, and IgE characterize multiple myeloma. Monoclonal elevations of IgM occur in macroglobulinemia.
Decreased immunoglobulin levels are found in patients with congenital deficiencies.
Interpretation
Increased serum immunoglobulin concentrations occur due to polyclonal or oligoclonal immunoglobulin proliferation in hepatic disease (eg, hepatitis, liver cirrhosis), connective tissue diseases, acute and chronic infections, as well as in the cord blood of neonates with intrauterine and perinatal infections.
Elevations of IgG, IgA, or IgM may occur in monoclonal gammopathies such as multiple myeloma (IgG, IgA), macroglobulinemia (IgM), primary systemic amyloidosis, monoclonal gammopathy of undetermined significance, and related disorders.
Decreased levels are found in patients with primary or secondary immune deficiencies.
Clinical Reference
1. Webster ADB: Laboratory Investigation of primary deficiency of the lymphoid system. In: Clinics in Immunology and Allergy. Vol 5. 3rd ed. WB Saunders Company; 1985:447-468
2. Pinching AJ: Laboratory investigation of secondary immunodeficiency. In: Clinics in Immunology and Allergy. Vol.5. 3rd ed. WB Saunders Company; 1985:469-490
3. Dispenzieri A, Gertz MA, Kyle RA: Distribution of diseases associated with moderate polyclonal gammopathy in patients seen at Mayo Clinic during 1991. Blood 1997;90:353
4. Kyle RA, Greipp PR: The laboratory investigation of monoclonal gammopathies. Mayo Clin Proc. 1978 Nov;53(11):719-739
5. Ballow M, O'Neil KM: Approach to the patient with recurrent infections. In: Middleton Jr E, Reed CE, Ellis EF, et al, eds. Allergy: Principles and Practice. Vol 2. 4th ed. Mosby-Year Book, Inc; 1993:1027-1058
6. Kyle RA: Detection of quantitation of monoclonal proteins. Clin Immunol Newsletter. 1990;10:84-86
7. Dietzen DJ, Willrich MAV: Amino acids, peptides, and proteins. In: Rifai N, Chiu RWK, Young I, Burnham CAD, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 31
Report Available
1 to 3 daysMethod Name
Nephelometry
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
Testing Algorithm
Special Instructions
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