Cell immunity test

Immunoglobulins

An immunoglobulins test is done to measure the level of immunoglobulins, also known as

antibodies, in your blood.

Antibodies are substances made by the body's immune system in response to bacteria,
viruses, fungus, animal dander, or cancer cells. Antibodies attach to the foreign
substances so the immune system can destroy them. See a picture of the immune
system .

Antibodies are specific to each type of foreign substance. For example, antibodies made
in response to a tuberculosis infection attach only to tuberculosis bacteria. Antibodies
also work in allergic reactions. Occasionally, antibodies may be made against your own
tissues. This is called an autoimmune disease.

If your immune system makes low levels of antibodies, you may have a higher chance of
developing repeated infections. You can be born with an immune system that makes low
levels of antibodies, or your system may make low levels of antibodies in response to
certain diseases, such as cancer.

The five major types of antibodies are:

* IgA. IgA antibodies are found in areas of the body such the nose, breathing passages,
digestive tract, ears, eyes, and vagina. IgA antibodies protect body surfaces that are
exposed to outside foreign substances. This type of antibody is also found in saliva, tears,
and blood. About 10% to 15% of the antibodies present in the body are IgA antibodies. A
small number of people do not make IgA antibodies.
* IgG. IgG antibodies are found in all body fluids. They are the smallest but most
common antibody (75% to 80%) of all the antibodies in the body. IgG antibodies are very
important in fighting bacterial and viral infections. IgG antibodies are the only type of
antibody that can cross the placenta in a pregnant woman to help protect her baby (fetus).
* IgM. IgM antibodies are the largest antibody. They are found in blood and lymph fluid
and are the first type of antibody made in response to an infection. They also cause other
immune system cells to destroy foreign substances. IgM antibodies are about 5% to 10%
of all the antibodies in the body.
* IgE. IgE antibodies are found in the lungs, skin, and mucous membranes. They cause
the body to react against foreign substances such as pollen, fungus spores, and animal
dander. They may occur in allergic reactions to milk, some medicines, and some poisons.
IgE antibody levels are often high in people with allergies.
* IgD. IgD antibodies are found in small amounts in the tissues that line the belly or
chest. How they work is not clear.

The levels of each type of antibody can give your doctor information about the cause of a
medical problem.
Why It Is Done

A test for immunoglobulins (antibodies) in the blood is done to:

* Find certain autoimmune diseases or allergies.

* Find certain types of cancer (such as multiple myeloma or macroglobulinemia).
* See whether recurring infections are caused by a low level of immunoglobulins
(especially IgG).
* Check the treatment for certain types of cancer affecting the bone marrow.
* Check the treatment for Helicobacter pylori (H. pylori) bacteria.
 * Check the response to immunizations to see if you are immune to the disease.

This test is often done when the results of a blood protein electrophoresis or total blood
protein test are abnormal.

ow It Is Done

The health professional drawing blood will:

* Wrap an elastic band around your upper arm to stop the flow of blood. This makes the
veins below the band larger so it is easier to put a needle into the vein.
* Clean the needle site with alcohol.
* Put the needle into the vein. More than one needle stick may be needed.
* Attach a tube to the needle to fill it with blood.
* Remove the band from your arm when enough blood is collected.
* Put a gauze pad or cotton ball over the needle site as the needle is removed.
* Put pressure to the site and then a bandage.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around
your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may
feel a quick sting or pinch.
Risks

There is very little chance of a problem from having blood sample taken from a vein.

* You may get a small bruise at the site. You can lower the chance of bruising by
keeping pressure on the site for several minutes.
* In rare cases, the vein may become swollen after the blood sample is taken. This
problem is called phlebitis. A warm compress can be used several times a day to treat
this.
* Ongoing bleeding can be a problem for people with bleeding disorders. Aspirin,
warfarin (Coumadin), and other blood-thinning medicines can make bleeding more likely. If
you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your
doctor before your blood sample is taken.

Results

An immunoglobulins test is done to measure the level of immunoglobulins, also known as

antibodies, in your blood.
Normal

Normal values may vary from lab to lab. The results listed below are normal values for
adults. Children have different values than adults. Results are ready in several days.

Immunoglobulins IgA

85-385 milligrams per deciliter (mg/dL) [0.85-3.85 grams per liter (g/L)]

IgG

565-1765 mg/dL (5.65-17.65 g/L)

IgM
55-375 mg/dL (0.55-3.75 g/L)

IgD

Less than 8 mg/dL [5-30 micrograms per liter (mcg/L)]

IgE

4.2-592 units per milliliter (U/mL) (10-1421 mcg/L)

High values

* IgA. High levels of IgA may mean monoclonal gammopathy of unknown significance
(MGUS) or multiple myeloma is present. Levels of IgA also get higher in some autoimmune
diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE), and in
liver diseases, such as cirrhosis and long-term (chronic) hepatitis.
* IgG. High levels of IgG may mean a long-term (chronic) infection, such as AIDS, is
present. Levels of IgG also get higher in IgG multiple myeloma, long-term hepatitis, and
multiple sclerosis (MS). In multiple myeloma, tumor cells make only one type of IgG
antibody (monoclonal); the other conditions cause an increase in many types of IgG
antibodies (polyclonal).
* IgM. High levels of IgM can mean macroglobulinemia, early viral hepatitis,
mononucleosis, rheumatoid arthritis, kidney damage (nephrotic syndrome), or a parasite
infection is present. Because IgM antibodies are the type that form when an infection
occurs for the first time, high levels of IgM can mean a new infection is present. High
levels of IgM in a newborn mean that the baby has an infection that started in the uterus
before delivery.
* IgD. How IgD works in the immune system is not clear. A high level may mean IgD
multiple myeloma. IgD multiple myeloma is much less common than IgA or IgG multiple
myeloma.
* IgE. A high level of IgE can mean a parasite infection is present. Also, high levels of
IgE are found in people who have allergic reactions, asthma, atopic dermatitis, some types
of cancer, and certain autoimmune diseases. In rare cases, a high level of IgE may mean
IgE multiple myeloma.

Low values

* IgA. Some people are born with low or absent levels of IgA antibodies. Low levels of
IgA occur in some types of leukemia, kidney damage (nephrotic syndrome), a problem
with the intestines (enteropathy), and a rare inherited disease that affects muscle
coordination (ataxia-telangiectasia). This increases their chances of developing an
autoimmune disease.
* IgG. Low levels of IgG occur in macroglobulinemia. In this disease, the high levels of
IgM antibodies stop the growth of cells that make IgG. Other conditions that can cause low
levels of IgG include some types of leukemia and a type of kidney damage (nephrotic
syndrome). In rare cases, some people are born with a lack of IgG antibodies. These
people are more likely to develop infections.
* IgM. Low levels of IgM occur in multiple myeloma, some types of leukemia, and in
some inherited types of immune diseases.
* IgE. Low levels of IgE can occur in a rare inherited disease that affects muscle
coordination (ataxia-telangiectasia).

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful
include:
 * Taking medicines, such as hydralazine, phenylbutazone, birth control pills,
anticonvulsants (such as phenytoin), methotrexate, aminophenazone, asparaginase, or
corticosteroids.
* Having cancer treatments, both radiation and chemotherapy.
* Receiving a blood transfusion in the past 6 months.
* Getting vaccinations (immunizations), especially vaccinations with repeat (booster)
doses, in the past 6 months.
* Using alcohol or illegal drugs.
* Having a radioactive scan in the past 3 days.

What To Think About

* Immunoglobulins are made specific to different illnesses. For example, the IgM
antibody for mononucleosis is different than the IgM for herpes. For this reason, a doctor
can look for an immunoglobulin to a specific illness to help diagnose that illness.
* Different antibodies can be used to help a doctor tell the difference between a new and
past infection. For example, IgM antibodies for mononucleosis with or without IgG
antibodies means a new mono infection. IgG antibodies without IgM means a past mono
infection.
* People with very low immunoglobulin levels, especially IgA, IgG, and IgM, have a
higher chance of developing an infection.
* A very small number of people cannot make IgA and have a higher chance of
developing a potentially life-threatening reaction to a blood transfusion.
* An immunoglobulin test is often done when the results of a blood protein
electrophoresis or total blood protein test are abnormal. For more information, see the
medical tests Serum Protein Electrophoresis (SPEP) and Total Serum Protein.