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Immunoglobulin G (IgG)


Definition


  • IgG activates complement and fights infection. IgG represents 70 " “80% of the total serum immunoglobulins in the normal adults. It exists in four subclasses (IgG1, IgG2, IgG3, and IgG4). IgG1 predominates as 65% of the total IgG. IgG of maternal origin provides passive immunity to the neonate. It is transported across the placenta.
  • Normal ranges: see Table 16.43.

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TABLE 16 " “43Normal Ranges for IgG by AgeView LargeTABLE 16 " “43Normal Ranges for IgG by Age Age Range (mg/dL) 0 " “30 d 611 " “1,542 1 m 241 " “870 2 mo 198 " “577 3 mo 169 " “558 4 mo 188 " “536 5 mo 165 " “781 6 mo 206 " “676 7 " “8 mo 208 " “868 9 " “11 mo 282 " “1,026 1 y 331 " “1,164 2 y 407 " “1,009 3 y 423 " “1,090 4 y 444 " “1,187 5 " “7 y 608 " “1,229 8 " “9 y 584 " “1,509 ≥10 y 768 " “1,632

Use


  • Diagnosis of IgG myeloma
  • Diagnosis of hereditary and acquired IgG immunodeficiencies
  • Serologic diagnosis of infectious diseases and immunity

Interpretation


Increased In


  • Monoclonal
    • Multiple myeloma
    • Solitary plasmacytoma
    • MGUS
    • Lymphoma
    • CLL
  • Polyclonal
    • Sarcoidosis
    • Chronic liver disease (e.g., cirrhosis)
    • Autoimmune diseases
    • Parasitic diseases
    • Chronic infection
    • Intrauterine contraceptive diseases

Decreased In


  • Protein-losing syndromes
  • Pregnancy
  • Non-IgG myeloma
  • Waldenstr ƒ śm macroglobulinemia
  • Primary immunodeficiency states
  • Combined with other immunoglobulin decreases:
    • Agammaglobulinemia
      • Acquired
      • Primary
      • Secondary (e.g., multiple myeloma, leukemia, nephrotic syndrome, protein-losing enteropathy)
      • Congenital
      • Hereditary thymic aplasia
      • Type I dysgammaglobulinemia (decreased IgG and IgA and increased IgM)
      • Type II dysgammaglobulinemia (absent IgA and IgM and normal levels of IgG)
      • Infancy, early childhood
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