NEWS

Few points on Immunoglobulins

Immunoglobulins are glycoprotein molecules that are produced by plasma cells in response to an immunogen and which function as antibodies. The immunoglobulins derive their name from the finding that they migrate with globular proteins when antibody-containing serum is placed in an electrical field.

      
    Source for preparation of Human Gamma GlobulinsPlacenta
    Smallest IgIg G 
    Largest IgIg M 
    Heat Labile IgIg E 
    Reagenic AntibodyIg E 
    Earliest Antibody to be Synthesised Ig M 
    Ig that crosses PlacentaIg G 
    Ig with Minimum LifeIg E 
    Ig that protects SurfacesIg A 
    Mainly Intravascular IgIg M 
    Warm AntibodiesIg G 
    Cold AntbodiesIg M 
    Ig Present in MilkIg G and Ig A 
    Commonest Ig Deficiency
    Deficiency of Ig A. 


CLINICAL IMPLICATIONS OF HUMAN IMMUNOGLOBULIN CLASSES

Adapted from:F.T. Fischbach in "A Manual of Laboratory Diagnostic Tests," 2nd Ed., J.B. Lippincott Co., Philadelphia, PA, 1984.

IgG

1. Increases in:
a) Chronic granulomatous infections
b) Infections of all types
c) Hyperimmunization
d) Liver disease
e) Malnutrition (severe)
f) Dysproteinemia
g) Disease associated with hypersensitivity granulomas, dermatologic disorders, and IgG myeloma
h) Rheumatoid arthritis

2. Decreases in:
a) Agammaglobulinemia
b) Lymphoid aplasia
c) Selective IgG, IgA deficiency
d) IgA myeloma
e) Bence Jones proteinemia
f) Chronic lymphoblastic leukemia


IgM

1. Increases (in adults) in:
a) Waldenström's macroglobulinemia
b) Trypanosomiasis
c) Actinomycosis
d) Carrión's disease (bartonellosis)
e) Malaria
f) Infectious mononucleosis
g) Lupus erythematosus
h) Rheumatoid arthritis
I) Dysgammaglobulinemia (certain cases)

Note: In the newborn, a level of IgM above 20 ng./dl is an indication of in utero stimulation of the immune system and stimulation by the rubella virus, the cytomegalovirus, syphilis, or toxoplasmosis.

2. Decreases in:
a) Agammaglobulinemia
b) Lymphoproliferative disorders (certain cases)
c) Lymphoid aplasia
d) IgG and IgA myeloma
e) Dysgammaglobulinemia
f) Chronic lymphoblastic leukemia


IgA

1. Increases in:
a) Wiskott-Aldrich syndrome
b) Cirrhosis of the liver (most cases)
c) Certain stages of collagen and other autoimmune disorders such as rheumatoid arthritis and lupus erythematosus
d) Chronic infections not based on immunologic deficiencies
e) IgA myeloma

2. Decreases in:
a) Hereditary ataxia telangiectasia
b) Immunologic deficiency states (e.g., dysgammaglobulinemia, congenital and acquired agammaglobulinemia, and hypogammaglobulinemia)
c) Malabsorption syndromes
d) Lymphoid aplasia
e) IgG myeloma
f) Acute lymphoblastic leukemia
g) Chronic lymphoblastic leukemia

IgD

1. Increases in:
a) Chronic infections
b) IgD myelomas

IgE

1. Increases in:
a) Atopic skin diseases such as eczema
b) Hay fever
c) Asthma
d) Anaphylactic shock
e) IgE-myeloma

2. Decreases in:
a) Congenital agammaglobulinemia
b) Hypogammaglobulinemia due to faulty metabolism or synthesis of immunoglobulins

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