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Unit Code 9272:
Immunoglobulin D (IgD), Serum

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Useful For

Quantitative determination of the immunoglobulins can

provide important information on the humoral immune status.

 

Changes in IgD concentration are used as a marker of changes in

the size of the clone of monoclonal IgD plasma cells.

Clinical Information

Antibodies or immunoglobulins (Ig) 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 also 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's macroglobulinemia,

primary amyloidosis, and monoclonal gammopathy of undetermined

significance (MGUS).

 

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.

Reference Values

< or =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 M-peak 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. #81756 "Monoclonal Protein Studies, Serum" should be

performed to distinguish between a polyclonal and monoclonal IgD.

Clinical Reference

1.   Blade J, 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

 

2.   Kyle RA, Katzmann JA:  Immunochemical characterization of

      immunoglobulins. In Manual of Clinical Laboratory Immunology.

      5th edition. Edited by NR Rose, E Conway de Macario, JD Folds,

      et al:  Washington, DC, ASM Press,1997, pp 156-176

 

3.   Tietz NW:  In Clinical Guide to Laboratory Tests. 2nd edition.

      Philadelphia, WB Saunders Company, 1990, p 325

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