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Test Code 4914 Immunoglobulin D (IgD), Serum

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Advisory Information


MPSS / Monoclonal Protein Studies, Serum should be performed to distinguish between polyclonal and monoclonal IgD.



Specimen Required


Patient Preparation: Fasting preferred but not required

Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 1 mL


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  21 days

Reference Values

≤10 mg/dL

Day(s) and Time(s) Performed

Monday through Saturday; Continuously until 3 p.m.

Test Classification

This test has been cleared or approved by the U.S. 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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IGD Immunoglobulin D (IgD), S 2460-4

 

Result ID Test Result Name Result LOINC Value
IGD Immunoglobulin D (IgD), S 2460-4

Clinical Information

Antibodies or immunoglobulins (Ig) are formed by plasma cells as a humoral immune response to antigens. The first antibodies formed after antigen stimulation are of the IgM class, followed later by IgG and also IgA antibodies. IgD normally occurs in serum in trace amounts.

 

Increased serum immunoglobulin concentrations occur due to polyclonal or oligoclonal immunoglobulin proliferation in hepatic diseases (chronic hepatitis, liver cirrhosis), acute and chronic infections, autoimmune diseases, as well as in the cord blood of neonates with intrauterine and perinatal infections. Increases in serum immunoglobulin concentration are seen in monoclonal gammopathies such as multiple myeloma, Waldenstrom macroglobulinemia, primary amyloidosis, and monoclonal gammopathy of undetermined significance.

 

Decreased serum immunoglobulin concentrations occur in primary immunodeficiency conditions as well as in secondary immune insufficiencies including advanced monoclonal gammopathies, lymphatic leukemia, and advanced malignant tumors.

 

Changes in IgD concentration are used as a marker of changes in the size of the clone of monoclonal IgD plasma cells.

Interpretation

The physiologic significance of serum IgD concentration is unclear and in many normal persons serum IgD is undetectable.

 

Increased concentrations may be due to polyclonal (reactive) or monoclonal plasma cell proliferative processes.

 

A monoclonal IgD protein is present in 1% of patients with myeloma. Monoclonal IgD proteins are often in low concentrations and do not have a quantifiable M-peak on serum protein electrophoresis. However, the presence of an IgD monoclonal protein is almost always indicative of a malignant plasma cell disorder such as multiple myeloma or primary amyloidosis.

Clinical Reference

1. Blade J, Kyle RA: Immunoglobulin D multiple myeloma: Presenting features, response to therapy, and survival in a series of 53 cases. J Clin Oncol 1994;12(11):2398-2404

2. Kyle RA, Katzmann JA: Immunochemical characterization of immunoglobulins. In Manual of Clinical Laboratory Immunology. Fifth edition. Edited by NR Rose, E Conway de Macario, JD Folds, et al: Washington, DC, ASM Press,1997, pp 156-176

3. Tietz NW: In Clinical Guide to Laboratory Tests. Second edition. Philadelphia, WB Saunders Company, 1990, p 325

Method Name

Nephelometry