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Test Name:
IgG Synthesis Rate


  • SBMF No:
    23069
  • Performance Lab Name:
    Immunology
  • Test Mnemonic:
    IGG-SYNTH
  • ABN:
    Not required
  • CPT Code:
    82040; 82042; 82784x2
  • LOINC Code:
    14116-8; 1746-7; 1751-7; 2464-6; 2465-3; 2470-3; 14117-6
  • Test Includes:
    Albumin, Serum
    IgG, Serum
    Albumin, CSF
    IgG, CSF
  • Also Known As:
    CSF IgG Index
    IgG Synthesis Index
  • Also See:
    42044 Oligoclonal Banding, Cerebrospinal Fluid and Serum
    44300 Myelin Basic Protein, by ELISA, Cerebrospinal Fluid
  • Spec Type:
    Cerebrospinal fluid (CSF), AND
    Serum
  • Spec Container:
    Two (2) containers:
    CSF: Sterile plastic tube with screw-top cap, AND
    Blood: Gold top (SST) or red top (serum) tube
  • Pref Vol:
    1.0 mL CSF, AND
    1.0 mL serum
  • Min Vol:
    0.5 mL CSF, AND
    0.5 mL serum
  • Fasting:
    No
  • Spec Collect:
    Cerebrospinal fluid: Collected by physician
    Blood: Routine venipuncture
  • Spec Process:
    Blood:
    – Clot 30 minutes
    – Promptly centrifuge 15 minutes
    – Immediately transfer serum to separate plastic tube
    CSF:
    – Promptly centrifuge 15 minutes
    – Immediately transfer supernatiant to separate plastic tube
  • Spec Store Transport:
    Refrigerated
  • Spec Stability:
    1 week refrigerated (2-8°C)
  • Spec Reject:
    Severely lipemic or hemolyzed sample
  • Methodology:
    Photometry and nephelometry
  • Use:
    Used to detect increased permeability of the blood/brain barrier to plasma proteins and to detect increased intrathecal production of immunoglobulins
  • Clinical Significance:
    The permeability of the blood-CSF barrier to plasma protein is increased by high intracranial pressure due to brain tumor, intracerebral hemorrhage, traumatic injury or by inflammation due to bacterial or viral meningitis, encephalitis or poliomyelitis. Demonstration of increased intrathecal synthesis of immunoglobulins, particularly IgG, has great importance in the diagnosis of demyelinating diseases of the Central Nervous System (CNS) especially multiple sclerosis (MS). In MS, patchy deterioration of the myelin sheaths of axions I the CNS profoundly affects conduction of nerve impulses.A complicating factor in testing for intrathecal IgG is that an increase in CSF IgG concentration or in the CSF/serum IgG concentration ratio may occur either because of increased permeability of the blood-CSF barrier or increased local production of IgG or both. To identify intrathecal production specifically, correction for increased permeability by including measurements of albumin in both serum and CSF is suitable because albumin is neither synthesized nor metabolized intrathecally.
  • Reference Range:

    Albumin, Serum: 3.5-5.2 g/dL
    Albumin, CSF: 0.0-35.0 mg/dL
    IgG, Serum: 694-1619 mg/dL
    IgG, CSF: 0.0-5.4 mg/dL
    IgG/Alb Ratio: < 0.28
    IgG/Alb Index: 0.3-0.7
    IgG Synthesis Rate: -9.9 to 3.3 mg/day

    Interpretive Data:
    IgG Synthesis Rate: Values exceeding 8 mg/day are interpreted as increased rate, as found in most cases of Multiple Sclerosis.

  • Day Run:
    Mon, Wed, Fri
  • Time Run:
    8:00 am
  • Time Reported:
    5:00 pm
  • Test Type:
    CSF

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