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EPIC CODE: LAB2558 Immunoglobulin D (IgD), Serum

Additional Codes

Sunquest:  IGDM
Mayo:         IGD
Previously: ARUP 0099200

Ordering Guidance

To distinguish between polyclonal and monoclonal IgD, order PEISO / Protein Electrophoresis and Isotype, Serum.

Specimen Required

Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Patient Preparation: Fasting preferred but not required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Secondary ID


Useful For

Providing information on the humoral immune status


Identifying an IgD monoclonal gammopathy

Method Name


Reporting Name

Immunoglobulin D (IgD), S

Specimen Type


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  21 days

Reject Due To

Gross hemolysis OK
Gross lipemia Reject
Gross icterus OK
Heat-activated specimen Reject

Clinical Information

Antibodies or immunoglobulins are formed by plasma cells as a humoral immune response to antigens. The first antibodies formed after antigen stimulation are of the IgM class, followed later by IgG and IgA antibodies. IgD normally occurs in serum in trace amounts.


Increased serum immunoglobulin concentrations occur due to polyclonal or oligoclonal immunoglobulin proliferation in hepatic diseases (chronic hepatitis, liver cirrhosis), acute and chronic infections, autoimmune diseases, as well as in the cord blood of neonates with intrauterine and perinatal infections. Increases in serum immunoglobulin concentration are seen in monoclonal gammopathies such as multiple myeloma, Waldenstrom macroglobulinemia, primary amyloidosis, and monoclonal gammopathy of undetermined significance.


Decreased serum immunoglobulin concentrations occur in primary immunodeficiency conditions as well as in secondary immune insufficiencies including advanced monoclonal gammopathies, lymphatic leukemia, and advanced malignant tumors.


Changes in IgD concentration are used as a marker of changes in the size of the clone of monoclonal IgD plasma cells.

Reference Values

≤10 mg/dL


The physiologic significance of serum IgD concentration is unclear and in many normal persons serum IgD is undetectable.


Increased concentrations may be due to polyclonal (reactive) or monoclonal plasma cell proliferative processes.


A monoclonal IgD protein is present in 1% of patients with myeloma. Monoclonal IgD proteins are often in low concentrations and do not have a quantifiable monoclonal protein on serum protein electrophoresis. However, the presence of an IgD monoclonal protein is almost always indicative of a malignant plasma cell disorder such as multiple myeloma or primary amyloidosis.


An elevated IgD cannot be taken as evidence for a monoclonal IgD protein. PEISO / Protein Electrophoresis and Isotype, Serum should be performed to distinguish between a polyclonal and monoclonal IgD.

Clinical Reference

1. Blade J, Lust JA, Kyle RA: Immunoglobulin D multiple myeloma: Presenting features, response to therapy, and survival in a series of 53 cases. J Clin Oncol. 1994;12(11):2398-2404. doi: 10.1200/JCO.1994.12.11.2398

2. Kyle RA, Katzmann JA: Immunochemical characterization of immunoglobulins. In: Rose NR, de Macario EC, Folds JD, et al: eds. Manual of Clinical Laboratory Immunology. 5th ed. ASM Press; 1997:156-176

3. Rifai N, Horvath AR, Wittwer C. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1888

Method Description

The determination of the soluble antigen concentration by turbidimetric methods involves the reaction with specific anti-serum to form insoluble complexes. When light is passed through the suspension formed a portion of the light is transmitted and focused onto a photodiode by an optical lens system. The amount of transmitted light is indirectly proportional to the specific protein concentration in the test sample. Concentrations are automatically calculated by reference to a calibrations curve stored within the instrument.(Package insert: Optilite IgD Kit. The Binding Site Group, Ltd; 08/2018)

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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


LOINC Code Information

Test ID Test Order Name Order LOINC Value
IGD Immunoglobulin D (IgD), S 2460-4


Result ID Test Result Name Result LOINC Value
IGD Immunoglobulin D (IgD), S 2460-4

NY State Approved