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HelpEpic Test Code LAB2293 Immunoglobulin D (IgD), Serum
Additional Codes
MML:IGD
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Minimum Volume
0.5 mL
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.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days | ||
| Ambient | 21 days |
Reference Values
≤10 mg/dL
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | Reject |
| Gross icterus | OK |
| Heat-activated specimen | Reject |
Reporting Name
Immunoglobulin D (IgD), SUseful For
Providing information on the humoral immune status
Identifying an IgD monoclonal gammopathy
Day(s) Performed
Monday through Friday
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.
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.
Report Available
1 to 3 daysSpecimen Retention Time
14 daysNY State Approved
YesMethod Name
Turbidimetry
CPT Code Information
82784