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HelpMayo Test ID IGD Immunoglobulin D (IgD), Serum
Ordering Guidance
To distinguish between polyclonal and monoclonal IgD, order PEISO / Protein Electrophoresis and Isotype, Serum.
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Patient Preparation: Fasting preferred but not required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Useful For
Providing information on the humoral immune status
Identifying an IgD monoclonal gammopathy
Method Name
Turbidimetry
Reporting Name
Immunoglobulin D (IgD), SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 21 days |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | Reject |
| Gross icterus | OK |
| Heat-activated specimen | Reject |
Clinical Information
Antibodies or immunoglobulins 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 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.
Reference Values
≤10 mg/dL
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 monoclonal protein 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.
Cautions
An elevated IgD cannot be taken as evidence for a monoclonal IgD protein. PEISO / Protein Electrophoresis and Isotype, Serum should be performed to distinguish between a polyclonal and monoclonal IgD.
Clinical Reference
1. Blade J, Lust JA, 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. doi: 10.1200/JCO.1994.12.11.2398
2. Kyle RA, Katzmann JA: Immunochemical characterization of immunoglobulins. In: Rose NR, de Macario EC, Folds JD, et al: eds. Manual of Clinical Laboratory Immunology. 5th ed. ASM Press; 1997:156-176
3. Rifai N, Horvath AR, Wittwer C. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1888
Method Description
The determination of the soluble antigen concentration by turbidimetric methods involves the reaction with specific anti-serum to form insoluble complexes. When light is passed through the suspension formed a portion of the light is transmitted and focused onto a photodiode by an optical lens system. The amount of transmitted light is indirectly proportional to the specific protein concentration in the test sample. Concentrations are automatically calculated by reference to a calibrations curve stored within the instrument.(Package insert: Optilite IgD Kit. The Binding Site Group, Ltd; 08/2018)
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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
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 |