IGG SYNTHESIS RATE

Code
000.0000
Name
IGG SYNTHESIS RATE
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
IgG Synthesis Index
CPT Codes
82040, 82042, 82784 x 2
Site
SBMF
Reference Test
23069
ATLAS Test Code

Specimen Information

Type

Cerebrospinal fluid (CSF), AND Serum (Gold Top SST)

Volume

Pref Vol:
1.0 mL CSF, AND
1.0 mL serum
Min Vol:
0.5 mL CSF, AND
0.5 mL serum

Transport Info

Refrigerated

Fasting Required?
False
Patient Instructions

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

Methodology

Photometry and nephelometry

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.

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