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Test Code IGGSB IgG Subclasses, Serum

Reporting Name

IgG Subclasses, S

Useful For

Second-order testing for evaluation of patients with clinical signs and symptoms of humoral immunodeficiency or combined immunodeficiency (cellular and humoral)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Advisory Information


If testing for immunoglobulin (Ig) G4-related diseases, the more appropriate test to order is IGGS4 / Immunoglobulin Subclass IgG4, Serum.



Specimen Required


Patient Preparation: Fasting preferred but not required

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.5 mL

Testing Algorithm

Testing includes total immunoglobulin G (IgG) as well as the 4 subclasses of IgG.

 

See Celiac Disease Diagnostic Testing Algorithm in Special Instructions

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Reference Values

TOTAL 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

 

IgG1

0-<5 months: 56-215 mg/dL  

5-<9 months: 102-369 mg/dL

9-<15 months: 160-562 mg/dL

15-<24 months: 209-724 mg/dL

2-<4 years: 158-721 mg/dL

4-<7 years: 209-902 mg/dL

7-<10 years: 253-1,019 mg/dL

10-<13 years: 280-1,030 mg/dL

13-<16 years: 289-934 mg/dL

16-<18 years: 283-772 mg/dL

≥18 years: 341-894 mg/dL

 

IgG2

0-<5 months: ≤82 mg/dL

5-<9 months: ≤89 mg/dL

9-<15 months: 24-98 mg/dL

15-<24 months: 35-105 mg/dL

2-<4 years: 39-176 mg/dL

4-<7 years: 44-316 mg/dL

7-<10 years: 54-435 mg/dL

10-<13 years: 66-502 mg/dL

13-<16 years: 82-516 mg/dL

16-<18 years: 98-486 mg/dL

≥18 years: 171-632 mg/dL

 

IgG3

0-<5 months: 7.6-82.3 mg/dL

5-<9 months: 11.9-74.0 mg/dL

9-<15 months: 17.3-63.7 mg/dL

15-<24 months: 21.9-55.0 mg/dL

2-<4 years: 17.0-84.7 mg/dL

4-<7 years: 10.8-94.9 mg/dL

7-<10 years: 8.5-102.6 mg/dL

10-<13 years: 11.5-105.3 mg/dL

13-<16 years: 20.0-103.2 mg/dL

16-<18 years: 31.3-97.6 mg/dL

≥18 years: 18.4-106.0 mg/dL

 

IgG4

0-<5 months: ≤19.8 mg/dL

5-<9 months: ≤20.8 mg/dL

9-<15 months: ≤22.0 mg/dL

15-<24 months: ≤23.0 mg/dL

2-<4 years: 0.4-49.1 mg/dL

4-<7 years: 0.8-81.9 mg/dL

7-<10 years: 1.0-108.7 mg/dL

10-<13 years: 1.0-121.9 mg/dL

13-<16 years: 0.7-121.7 mg/dL

16-<18 years: 0.3-111.0 mg/dL

≥18 years: 2.4-121.0 mg/dL

Day(s) and Time(s) Performed

Monday through Friday; Continuously

Test Classification

This test has been cleared, approved or is exempt 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

82787 x 4

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IGGS IgG Subclasses, S 47289-4

 

Result ID Test Result Name Result LOINC Value
T_IGG Total IgG 2465-3
IGG1 IgG 1 2466-1
IGG2 IgG 2 2467-9
IGG3 IgG 3 2468-7
IGG4 IgG 4 2469-5

Clinical Reference

Umetsu DT, Ambrosino DM, Quinti I, et al: Recurrent sinopulmonary infection and impaired antibody response to bacterial capsular polysaccharide antigen in children with selective IgG-subclass deficiency. N Engl J Med 1985;313:1247-1251

Method Description

In this Siemens Nephelometer II method, the light scattered onto the antigen-antibody complexes is measured. The intensity of the measured scattered light is proportional to the amount of antigen-antibody complexes in the sample under certain conditions. If the antibody volume is kept constant, the signal behaves proportionally to the antigen volume.

 

A reference curve is generated by a standard with a known antigen content on which the scattered light signals of the samples can be evaluated and calculated as an antigen concentration. Antigen-antibody complexes are formed when a sample containing antigen and the corresponding antiserum are put into a cuvette. A light beam is generated with a light emitting diode (LED), which is transmitted through the cuvette. The light is scattered onto the immuno-complexes that are present. Antigen and antibody are mixed in the initial measurement, but no complex is formed yet. An antigen-antibody complex is formed in the final measurement.

 

The result is calculated by subtracting value of the final measurement from the initial measurement. The distribution of intensity of the scattered light depends on the ratio of the particle size of the antigen-antibody complexes to the radiated wavelength.(Instruction manual: Siemens Nephelometer II, Siemens, Inc, Newark, DE, Version 3, 2008; Schauer U, Stemberg F, Rieger CH, et al: IgG subclass concentration in certified reference material 470 and reference values for children and adults determined with The Binding Site Reagents. Clin Chem 2003;49[11]:1924-1929)

Analytic Time

Same day/1 day

Reject Due To

Gross hemolysis OK
Gross lipemia Reject
Gross icterus OK

Method Name

Nephelometry

Secondary ID

9259