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HelpTest Code IGGS IgG Subclasses, Serum
Reporting Name
IgG Subclasses, SUseful For
Second-order testing for evaluation of patients with clinical signs and symptoms of humoral immunodeficiency or combined immunodeficiency (cellular and humoral)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
If testing for immunoglobulin subclass IgG4-related disease, the most appropriate test to order is IGGS4 / IgG4, Immunoglobulin Subclasses, Serum.
Specimen Required
Patient Preparation: Fasting preferred but not required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reference Values
TOTAL IgG
0-<5 months: 100-334 mg/dL
5-<9 months: 164-588 mg/dL
9-<15 months: 246-904 mg/dL
15-<24 months: 313-1,170 mg/dL
2-<4 years: 295-1,156 mg/dL
4-<7 years: 386-1,470 mg/dL
7-<10 years: 462-1,682 mg/dL
10-<13 years: 503-1,719 mg/dL
13-<16 years: 509-1,580 mg/dL
16-<18 years: 487-1,327 mg/dL
≥18 years: 767-1,590 mg/dL
IgG1
0-<5 months: 56-215 mg/dL
5-<9 months: 102-369 mg/dL
9-<15 months: 160-562 mg/dL
15-<24 months: 209-724 mg/dL
2-<4 years: 158-721 mg/dL
4-<7 years: 209-902 mg/dL
7-<10 years: 253-1,019 mg/dL
10-<13 years: 280-1,030 mg/dL
13-<16 years: 289-934 mg/dL
16-<18 years: 283-772 mg/dL
≥18 years: 341-894 mg/dL
IgG2
0-<5 months: ≤82 mg/dL
5-<9 months: ≤89 mg/dL
9-<15 months: 24-98 mg/dL
15-<24 months: 35-105 mg/dL
2-<4 years: 39-176 mg/dL
4-<7 years: 44-316 mg/dL
7-<10 years: 54-435 mg/dL
10-<13 years: 66-502 mg/dL
13-<16 years: 82-516 mg/dL
16-<18 years: 98-486 mg/dL
≥18 years: 171-632 mg/dL
IgG3
0-<5 months: 7.6-82.3 mg/dL
5-<9 months: 11.9-74.0 mg/dL
9-<15 months: 17.3-63.7 mg/dL
15-<24 months: 21.9-55.0 mg/dL
2-<4 years: 17.0-84.7 mg/dL
4-<7 years: 10.8-94.9 mg/dL
7-<10 years: 8.5-102.6 mg/dL
10-<13 years: 11.5-105.3 mg/dL
13-<16 years: 20.0-103.2 mg/dL
16-<18 years: 31.3-97.6 mg/dL
≥18 years: 18.4-106.0 mg/dL
IgG4
0-<5 months: ≤19.8 mg/dL
5-<9 months: ≤20.8 mg/dL
9-<15 months: ≤22.0 mg/dL
15-<24 months: ≤23.0 mg/dL
2-<4 years: ≤49.1 mg/dL
4-<7 years: ≤81.9 mg/dL
7-<10 years: 1.0-108.7 mg/dL
10-<13 years: 1.0-121.9 mg/dL
13-<16 years: ≤121.7 mg/dL
16-<18 years: < or=111.0 mg/dL
≥18 years: 2.4-121.0 mg/dL
Day(s) Performed
Monday through Friday
Test Classification
This test has been cleared, approved, or is exempt by the US 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
82787 x 4
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| IGGS | IgG Subclasses, S | 47289-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| T_IGG | Total IgG | 2465-3 |
| IGG1 | IgG 1 | 2466-1 |
| IGG2 | IgG 2 | 2467-9 |
| IGG3 | IgG 3 | 2468-7 |
| IGG4 | IgG 4 | 2469-5 |
Interpretation
Diminished concentrations of all IgG subclasses are found in common variable immunodeficiency, combined immunodeficiency, ataxia telangiectasia, and other primary and acquired immunodeficiency diseases.
A diminished concentration of IgG2 protein may be clinically significant in the context of recurrent sinopulmonary infection and may occur with or without concomitant IgA deficiency.
Elevated concentration of IgG4 is consistent with, but not diagnostic of, IgG4-related disease.
Slightly diminished concentrations of 1 or more IgG subclass proteins are not uncommon, and usually have little clinical significance.
Conversely, some individuals with deficient specific antibody responses to polysaccharide antigens may have normal serum concentrations of IgG subclasses.
Clinical Reference
1. Schauer U, Stemberg F, Rieger CHL, et al. IgG subclass concentration in certified reference material 470 and reference values for children and adults determined with the binding site reagents. Clin Chem. 2003;49(11):1924-1929
2. Dietzen DJ. Amino acids, peptides, and proteins. In: Rifai N, Horvath AR, Wittwer C, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:393-394
3. Vidarsson G, Dekkers G, Rispens T. IgG subclasses and allotypes: From structure to effector functions. Front Immunol. 2014;5:520
4. Napodano C, Marino M, Stefanile A, et al. Immunological role of IgG subclasses. Immunol Invest. 2021;50(4):427-444
5. Barton JC, Barton JC, Bertoli LF, Acton RT. Factors associated with IgG levels in adults with IgG subclass deficiency. BMC Immunol. 2021;22(1):53
Report Available
Same day/1 to 3 daysMethod Name
Turbidimetry
Testing Algorithm
Testing includes total IgG as well as the 4 subclasses of IgG.
For more information see Celiac Disease Diagnostic Testing Algorithm
Special Instructions
Forms
If not ordering electronically, complete, print, and send General Request (T239)