Immunoglobulin M, Quantitative

CPT: 82784
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Test Details

Synonyms

  • IgM, Serum
  • Quantitative IgM, Serum

Test Includes

Quantitation of IgM

Use

Evaluate humoral immunity; establish the diagnosis and monitor therapy in macroglobulinemia of Waldenström or plasma cell myeloma. IgM levels are used to evaluate likelihood of in utero infections or acuteness of infection.

Methodology

Immunoturbidimetric

Reference Interval

See table.

Immunoglobulin M, Quantitative

Age

Range (mg/dL)

Male

0 to 10 d

3−10

11 d to 6 m

18−91

7 to 11 m

27−112

1 to 3 y

39−146

4 to 6 y

40−152

7 to 9 y

37−151

10 to 11 y

36−153

12 to 13 y

36−156

14 to 15 y

35−163

16 to 19 y

35−168

20 to 70 y

20−172

>70 y

15−143

Female

0 to 10 d

1−19

11 d to 6 m

18−96

7 to 11 m

32−127

1 to 3 y

45−163

4 to 6 y

51−181

7 to 9 y

51−187

10 to 11 y

53−194

12 to 13 y

57−209

14 to 15 y

59−220

16 to 19 y

58−230

>19 y

26−217

Additional Information

Immunoglobulin M is a pentamer of 7S γ-globulin and is an efficient complement binder. It is the antibody type produced initially in the immune response and the first immunoglobulin class to be synthesized by a fetus or newborn. IgM antibodies do not cross the placenta. For these reasons the demonstration of IgM-specific antibody is useful in assessing whether a particular infection is acute (in which case IgM antibodies will be present) or chronic (IgG antibodies will predominate) and whether a newborn has a congenital infection (a newborn with IgM antibody is infected; a newborn with IgG antibody has passively acquired maternal antibody, which simply crossed the placenta). In the hyper-IgM immunodeficiency syndrome, there is an absence of IgG and IgA in serum and a marked increase in IgM. Macroglobulins produced in Waldenström disease are IgM, and may produce hyperviscosity syndrome. More than 2 g/dL of monoclonal IgM is a major diagnostic criterion of myeloma. Increased IgM (with other immunoglobulins) may develop in inflammatory/infectious conditions. IgM is characteristically elevated in primary biliary cirrhosis. The majority of rheumatoid factors are IgM. IgM will be decreased in congenital or acquired hypogammaglobulinemia, and this will be associated with increased, recurrent infection.

Specimen Requirements

Specimen

Serum

Volume

1 mL (adult), 0.4 mL (pediatric)

Minimum Volume

0.4 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Samples suspected of having macroglobulins or cryoglobulins should be drawn and held at 37°C. Samples suspected of containing cold agglutinins should not be refrigerated prior to serum separation from clot.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Excessive lipemia

Clinical Information

Special Instructions

Indicate the patient's age on the test request form.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001792 Immunoglobulin M, Qn, Serum 2472-9 001792 Immunoglobulin M, Qn, Serum mg/dL 2472-9

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The LOINC® codes are copyright © 1994-2018, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf