Laboratory Lab results are too important to go anywhere else.

GAM (IgG, IgA, IgM)

Immunoglobulin G, Immunoglobulin A, Immunoglobulin M, GAM (Immunoglobulins (IgG, IgA, IgM))

Test Codes

EPIC: LAB5785, GAM

Department

Chemistry

Instructions

This test contains Immunoglobulin G, Immunoglobulin A, and Immunoglobulin M.

Specimen Collection Criteria

Collect: One Gold-top SST tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within eight hours of collection.

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL serum)

Rejection Criteria

Grossly lipemic specimens.

Hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of eight hours.

For more information on this test please see procedures at 

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gel
Room Temperature (20-25°C or 68-77°F): 12 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Chemistry Laboratory
Royal Oak Automated Chemistry Laboratory

Performed

Sunday – Friday.
Results available within 24 hours of receipt in the Laboratory.

Reference Range

IGA	< 1 Year 1 - 2 Years 3 - 5 Years 6 - 13 Years 14 - 18 Years Adult	0 0 30 50 50 70	30 90 150 220 209 365	mg/dL
IGE			< 100	IU/mL
IGG	0 - 14 Days 15 Days - 11 Months 1 - 3 Years 4 - 9 Years 10 - 18 Years Adult	320 110 320 540 660 550	140 700 1150 1360 1530 1650	mg/dL

Methodology: Immunoturbidimetric

Test Methodology

Nephelometry.

Interpretation

• Decreased IgG levels are associated with selective hypo-IgG, protein losing enteropathies, pregnancy, and nephrotic syndrome.
• Increased IgG levels are associated with infectious diseases (hepatitis, rubella, infectious mononucleosis), parasitic diseases, rheumatoid arthritis, systemic lupus erythematosus, polyclonal and monoclonal gammopathies, multiple myeloma, monocytic leukemia, and Hodgkin's disease.
• Decreased IgA levels are associated with selective hypo-IgA, protein-losing enteropathies, hereditary ataxia telangiectasia, and nephrotic syndrome.
• Increased IgA levels are associated with infectious diseases, rheumatoid arthritis, polyclonal gammopathies, monocytic leukemia, IgA myeloma, and liver disease.
• Decreased IgM levels are associated with selective hypo-IgM and protein losing enteropathies.
• Increased IgM levels are associated with acute viral infections, recent immunization, parasitic disorders (e.g. trypanosomiasis, malaria, toxoplasmosis), Waldenstrom's macroglobulinemia, IgM myeloma, hyper-IgM syndrome, and hepatitis.
• IgG Half Life in Blood: 21 days.
• IgA Half Life in Blood: 6 days.
• IgM Half Life in Blood: 5 days.

Clinical Utility

• IgG levels can be used to evaluate humoral immunity and aids in the diagnosis of conditions associated with IgG excess or depression. IgG can cross the placenta. IgG antibodies are the most important and persistent antibodies of the secondary immune response.
• IgA levels are used to evaluate humoral immunity and to aid in the diagnosis of conditions associated IgA excess or depression. IgA represents 15-20% of the total circulating immunoglobulin pool. It is the predominant immunoglobulin in secretions such as tears, saliva, colostrum, milk, and intestinal secretions.
• IgM levels can be used to evaluate humoral immunity and to assist in the diagnosis of conditions associated with IgM excess or depression. IgM is the first antibody to appear in a primary antibody response. IgM does not cross the placenta. Increased IgM levels in the newborn are associated with intrauterine infections.

Clinical Disease

Selective IgA deficiency is a primary immunodeficiency disorder characterized by reduced production of IgA with recurrent respiratory and gastrointestinal infections. Selective IgA deficiency can result from congenital intrauterine infection with rubella virus. Toxoplasma gondii, or cytomegalovirus. A transient IgA deficiency may result following the treatment with penicillamine of Wilson's disease. Most patients with selective IgA deficiencies are asymptomatic. Symptomatic patients usually present with recurrent ear infections, sinusitis, pneumonia, diarrhea, asthma, autoimmune diseases and/or allergies. Administration of blood products containing IgA can cause some IgA deficient patients to develop antibodies against IgA. If an anti-IgA antibody develops, a massive allergic reaction can result during blood or plasma transfusion.

CPT Codes

82784x3.

Contacts

Last Updated

10/7/2023