Turnaround times
The quoted turnaround time is from sample receipt in the laboratory, to results authorisation in the Laboratory Information Management system. The times do not include transport of specimen to the laboratory or the administrative process to print and post/email reports. Service users must allow for transport and reporting time when ordering tests.
Clinical background:
Measurement of serum immunoglobulins is indicated in the investigation of suspected myeloma, Waldenstrom’s macroglobulinaemia, lymphoma and immunodeficiency. The measurement of immunoglobulins is always accompanied by serum electrophoresis, as this is essential for the interpretation of results.
Polyclonal elevations of all classes of immunoglobulins may be seen in chronic infection (e.g. HIV) or inflammation (e.g. Sjogren’s syndrome and sarcoidosis). IgA may be raised in chronic infections, lung disease, the elderly and in some cases of liver disease (e.g. cirrhosis). A raised IgM may be seen in acute infections and is a feature of primary biliary cirrhosis.
Guidelines for the Interpretation and Management of Immunoglobulins and Paraproteins in Adults is available is the site resources.
Specimen container paediatric:
Serum (SST or plain tube)
Specimen container adult:
Serum (SST or plain tube)
Minimum volume paediatric:
1 ml
Minimum volume adult:
2 ml
Sample stability:
IgA
- Unseparated sample:
- 8 days
- Separated sample:
- 8 months at 15 to 25oC,
- 2 to 8oC and -20oC
IgG
- Unseparated sample:
- 11 days
- Separated sample:
- 4 months at 15 to 25oC,
- 8 months at 2 to 8oC and -20oC
IgM
- Unseparated sample:
- 17 days
- Separated sample:
- 2 months at 15 to 25oC,
- 4 months at 2 to 8oC,
- 6 months at -20oC
Freq analysis:
Daily
Add on test:
All urgent add ons via telephone on 0191 282 4766, and must be confirmed via email to the appropriate email address [email protected]
Quality assurance:
- UK NEQAS for Monoclonal Protein Identification
- UK NEQAS for Specific Proteins
Interpretation:
Significant immunodeficiency may be present with normal immunoglobulins, further investigations may include specific antibodies or IgG subclasses, and these should be requested after discussion with an immunologist (adult or paediatric).
Reference ranges:
| Age Range | IgG (g/L) | IgA (g/L) |
| 0 – 14d | 5.0 – 17.0 | 0.01 – 0.08 |
| 2w – 5w | 3.9 – 13.0 | 0.02 – 0.15 |
| 6w – 2m | 2.1 – 7.7 | 0.05 – 0.40 |
| 3m – 5m | 2.4 – 8.8 | 0.10 – 0.50 |
| 6m – 8m | 3.0 – 9.0 | 0.15 – 0.70 |
| 9m – 12m | 3.0 – 10.9 | 0.20 – 0.70 |
| 1y | 3.1 – 13.8 | 0.30 – 1.20 |
| 2y | 3.7 – 15.8 | 0.30 – 1.30 |
| 3 – 5y | 4.9 – 16.1 | 0.40 – 2.00 |
| 6 – 8y | 4.9 – 16.1 | 0.50 – 2.40 |
| 9 – 11y | 4.9 – 16.1 | 0.70 – 2.50 |
| 12 – 14y | 5.4 – 16.1 | 0.80 – 2.80 |
| Adult Male | 5.8 – 15.4 | 0.64 – 2.97 |
| Adult Female | 5.8 – 15.4 | 0.64 – 2.97 |
Adult ranges from Oxford Handbook of Clinical Immunology and Allergy 3rd Edition 2013
| Age Range | Gender | IgM (d/L) |
| 0 – 14d | All | 0.05 – 0.20 |
| 2w – 5w | All | 0.08 – 0.40 |
| 6w – 2m | All | 0.15 – 0.70 |
| 3m – 5m | All | 0.20 – 1.00 |
| 6m – 8m | All | 0.40 – 1.60 |
| 9m – 12m | All | 0.60 – 2.10 |
| 1y | All | 0.60 – 2.10 |
| 2y | All | 0.50 – 2.20 |
| 3 – 4y | All | 0.50 – 2.00 |
| 5-9Y | M | 0.36 – 1.86 |
| F | 0.44 – 2.23 | |
| 10-14Y | M | 0.38 – 1.83 |
| F | 0.52 – 2.63 | |
| 15-19Y | M | 0.39 – 2.20 |
| F | 0.50 – 2.69 | |
| 20-39Y | M | 0.33 – 2.34 |
| F | 0.33 – 2.34 | |
| 40-59Y | M | 0.28 – 2.35 |
| F | 0.36 – 2.89 | |
| 60-79Y | M | 0.23 – 2.32 |
| F | 0.28 – 2.67 | |
| 80-99Y | M | 0.20 – 2.20 |
| F | 0.23 – 2.57 |
Adult ranges from Oxford Handbook of Clinical Immunology and Allergy 3rd Edition 2013