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Immunoglobulin G, Quantitative, Cerebrospinal Fluid

CPT: 82784
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Synonyms

  • Cerebrospinal Fluid IgG
  • CSF IgG
  • CSF Immunoglobulin G
  • IgG, CSF
  • IgG, Quantitative, CSF
  • Immunoglobulin G, CSF

Test Includes

Quantitation of CSF IgG


Special Instructions

The third tube of a routinely obtained three-tube set of CSF should be used for CSF IgG study.


Expected Turnaround Time

2 - 5 days


Related Documents


Specimen Requirements


Specimen

Cerebrospinal fluid (CSF)


Volume

0.5 mL


Minimum Volume

0.25 mL


Container

Sterile container


Storage Instructions

Room temperature


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x2


Causes for Rejection

Excessive blood in CSF


Test Details


Use

Evaluate central nervous system involvement by infection, neoplasm, or primary neurologic disease (in particular, multiple sclerosis)


Limitations

Normal levels do not exclude disease; clinical correlation must be applied.


Methodology

Immunologic


Reference Interval

See table.

Age

Male (mg/dL)

Female (mg/dL)

0 to 1 y

Not established

Not established

2 to 12 y

0.0−4.3

0.0−4.3

13 to 17 y

0.0−5.2

0.0−5.2

>17 y

0.0−10.3

0.0−6.7


Additional Information

Cerebrospinal fluid protein is elevated in many conditions which affect the central nervous system primarily or secondarily. In inflammatory or destructive processes in which serum leaks into CSF, both IgG and albumin will be present in the CSF in increased amounts. Since albumin is not, but immunoglobulins are, synthesized in the central nervous system, a relative increase in CSF IgG indicates presence of a process involving the central nervous system primarily, in particular multiple sclerosis.

IgG showed marked elevation (>16 mg/dL) in 36% of MS patients with only 1% of non-MS controls having this degree of increase. In the slightly elevated category (11% to 16%) however, there was considerable overlap with 38% of MS patients and 27% of non-MS patients falling into this category. While MS patients are maintained on ACTH and/or steroid therapy or during remission, CSF IgG levels decrease but generally remain significantly elevated.


LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
012211 Immunoglobulin G, Quant, CSF 2464-6 012212 IgG, Quant, CSF mg/dL 2464-6

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The LOINC® codes are copyright © 1994-2021, 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