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Sample 

Indications

  1. Used to detect monoclonal gammopathy.
  2. It is advised in immune deficiencies.

Pathophysiology 

  1. IgM exists in two form 
  2.     Monomeric IgM form exists as B- cell receptor for antigen.

                                                                     

  1.   Pentameric IgM form is present in the blood. These five basic units are joined by the J-chain.

  1. It is 10 % of the total immunoglobulin with a molecular weight of 900,000 and is 19 S.
    1. Its concentration is 120 mg/dl.
    2. Its molecular weight is 900,000 and 19S.
  2. There are 10 potential sites for antigen binding.
  3. IgM is the first antibody production in response to antigenic stimulation called Primary immune response.
    1. In primary response, there is stimulation of B-Lymphocytes which form the plasma cells and produce IgM.
  4. IgM as pentamer form is a most effective stimulator of complement system for lytic reaction.
  5. In fetal life, this is the first immunoglobulin which appears first and its raised level in neonate indicate intrauterine infection.
  6. IgM has a half-life of 10 days.
  7. It is predominantly present in the intravascular spaces.
  8. It is poor toxin neutralizing antibody.

Normal Level

Source 1

Age mg/dL
Cord blood <25
one month 20 to 80
2 to 5 month 25 to 100
6 to 9 month 35 to 125
10 to 12 month 40 to 150
1 to 8 year 45 to 200
9 to 12 year 50 to 250
>12 year 50 to 300

Source 2

Another source

  1. 0 to <5 months = 26 to 122 mg/d
  2. 15 to <24 months = 46 to 152 mg/dL
  3. 2 to <4 years = 37 to 184 mg/d
  4. 10 to <13 years = 41 to 255 mg/dL
  5. 16 to <18 years =  49 to 201 mg/dL
  6. More than 18 years = 37 to 286 mg/dL
    1. Values vary from the different methodolgy.

Decreased level of IgM seen in:

Increased level of IgM seen in :

  1. Elevations of IgM may be due to polyclonal immunoglobulin production which was seen in various infections.
  2. An isolated increase in IgM level may be seen in viral infections e.g. Viral hepatitis, infectious mononucleosis, and early response to bacterial or parasitic infection.
  3. Increased level of IgM may be seen in Rheumatoid arthritis, biliary cirrhosis, and some other chronic disorders.
  4. Raised levels are also seen in Hyper IgM dysgammaglobulinemia, active sarcoidosis, collagen vascular diseases, nephrotic syndrome.
  5. Monoclonal  raised levels are seen in :
    1. Waldenstrom's globulinemia.
    2. Lymphomas.

Possible References Used

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