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Test Code IGA Immunoglobulin A (IgA), Serum

Reporting Name

Immunoglobulin A (IgA), S

Useful For

Detection or monitoring of monoclonal gammopathies and immune deficiencies

Testing Algorithm

The following algorithms are available in Special Instructions:

-Celiac Disease Comprehensive Cascade

-Celiac Disease Diagnostic Testing Algorithm

-Celiac Disease Gluten-Free Cascade

-Celiac Disease Routine Treatment Monitoring Algorithm

-Celiac Disease Serology Cascade

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reference Values

0-<5 months: 7-37 mg/dL

5-<9 months: 16-50 mg/dL

9-<15 months: 27-66 mg/dL

15-<24 months: 36-79 mg/dL

2-<4 years: 27-246 mg/dL

4-<7 years: 29-256 mg/dL

7-<10 years: 34-274 mg/dL

10-<13 years: 42-295 mg/dL

13-<16 years: 52-319 mg/dL

16-<18 years: 60-337 mg/dL

≥18 years: 61-356 mg/dL

Day(s) and Time(s) Performed

Monday through Saturday; Continuously until 3 p.m.

Test Classification

This test has been cleared or approved 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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
IGA Immunoglobulin A (IgA), S 2458-8

 

Result ID Test Result Name Result LOINC Value
IGA Immunoglobulin A (IgA), S 2458-8

Clinical Information

The gamma globulin band as seen in conventional serum protein electrophoresis consists of 5 immunoglobulins. In normal serum, about 15% is immunoglobulin A (IgA).

 

Monoclonal gammopathies of all types may lead to a spike in the gamma globulin zone seen on serum protein electrophoresis.

 

Monoclonal elevations of IgA characterize multiple myeloma.

 

Decreased immunoglobulin levels are found in patients with congenital deficiencies.

 

For your convenience, we recommend utilizing cascade testing for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation. Algorithms for the cascade tests are available in Special Instructions.

-CDCOM / Celiac Disease Comprehensive Cascade: complete testing including HLA DQ

-CDSP / Celiac Disease Serology Cascade: complete testing excluding HLA DQ

-CDGF / Celiac Disease Gluten-Free Cascade: for patients already adhering to a gluten-free diet

To order individual tests, see Celiac Disease Diagnostic Testing Algorithm in Special Instructions.

Interpretation

Increased serum immunoglobulin concentrations occur due to polyclonal or oligoclonal immunoglobulin proliferation in hepatic disease (hepatitis, liver cirrhosis), connective tissue diseases, acute and chronic infections, as well as in the cord blood of neonates with intrauterine and perinatal infections.

 

Elevation of immunoglobulin A may occur in monoclonal gammopathies such as multiple myeloma, primary systemic amyloidosis, monoclonal gammopathy of undetermined significance, and related disorders.

 

Decreased levels are found in patients with primary or secondary immune deficiencies.

Clinical Reference

1. Webster ADB: Laboratory investigation of primary deficiency of the lymphoid system. In Clinics in Immunology and Allergy. Vol 5. Third edition. Philadelphia, WB Saunders Company, 1985, pp 447-468

2. Pinching AJ: Laboratory investigation of secondary immunodeficiency. In Clinics in Immunology and Allergy. Vol 5. Third edition. Philadelphia, WB Saunders Company, 1985, pp 469-490

3. Dispenzieri A, Gertz MA, Kyle RA: Distribution of diseases associated with moderate polyclonal gammopathy in patients seen at Mayo Clinic during 1991. Blood 1997;90:353

4. Kyle RA, Greipp PR: The laboratory investigation of monoclonal gammopathies. Mayo Clin Proc 1978;53:719-739

5. Ballow M, O'Neil KM: Approach to the patient with recurrent infections. In Allergy: Principles and Practice. Vol 2. Fourth edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis, MO, Mosby-Year Book, Inc., 1993, pp 1027-1058

6. Kyle RA: Detection of quantitation of monoclonal proteins. Clin Immunol Newsletter 1990;10:84-86

Analytic Time

1 day

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross OK

Other

NA

Method Name

Nephelometry

Forms

If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request Form (T728) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/gastroenterology-and-hepatology-test-request.pdf)