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25681 IgG4, Immunoglobulin Subclasses, Serum (IGGS4)

IgG4, Immunoglobulin Subclasses, Serum (IGGS4)
Test Code: IGGS4SO
Test Components

​ IgG4, Ig Subclasses

Useful For
Supporting the diagnosis of IgG4-related disease.

This test only quantitates the IgG4 protein. If quantitation of all IgG subclass types is desired, order IGGS / IgG Subclasses, Serum.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL ​0.5 mL
Collection Processing Instructions

​Fasting preferred but not required.

Centrifuge and aliquot serum into a plastic vial.

Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerate (preferred) ​14 days
​Ambient ​14 days
​Frozen ​14 days
Rejection Criteria
Gross Lipemia and gross hemolysis.
Interference
Elevations in serum IgG4 concentrations are not specific to IgG4-related disease; they are also found in disorders such as multicentric Castleman disease, allergic disorders, Churg-Strauss syndrome, sarcoidosis, and a large number of other conditions.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories​ ​Monday through Friday 1-2 days ​Turbidimetry
Reference Lab
Test Information

 The most abundant immunoglobulin isotype in human serum is IgG. IgG immunoglobulins are comprised of 4 subclasses, designated IgG1 through IgG4. Of total IgG, approximately 65% is IgG1, 25% is IgG2, 6% is IgG3, and 4% is IgG4. Each IgG subclass contains structurally unique portions of the constant region of the gamma heavy chain.

IgG subclass 4-related disease is a  systemic inflammatory disease of unknown etiology, most often occurring in middle-aged and older men. Several organ systems can be involved, and the disease encompasses many previous and newly described diseases such as autoimmune pancreatitis; Mikulicz disease and sclerosing sialadenitis; inflammatory orbital pseudotumor; chronic sclerosing aortitis; Riedel thyroiditis, a subset of Hashimoto thyroiditis; IgG4-related interstitial pneumonitis; and IgG4-related tubulointerstitial nephritis. These entities may be characterized by tumor-like swelling of the involved organs with infiltration by numerous IgG4-positive plasma cells with accompanying fibrosis. In addition, elevated serum concentrations of IgG4 are found in at least 50% of patients diagnosed with IgG4-related disease.

The diagnosis of IgG4-related disease may require a tissue biopsy of the affected organ demonstrating the aforementioned histological features. It is recommended that patients suspected of having an IgG4-related disease have their serum IgG4 measured. 

Reference Range Information
0-<5 months: < or =19.8 mg/dL
5-<9 months: < or =20.8 mg/dL
9-<15 months: < or =22.0 mg/dL
15-<24 months: < or =23.0 mg/dL
2-<4 years:< or =49.1 mg/dL
4-<7 years: < or = 81.9 mg/dL
7-<10 years: 1.0-108.7 mg/dL
10-<13 years: 1.0-121.9 mg/dL
13-<16 years: < or =121.7 mg/dL
16-<18 years: < or = 111.0 mg/dL
> or =18 years: 2.4-121.0 mg/dL
Interpretation
Elevated concentration of IgG4 is consistent with, but not diagnostic of, IgG4-related disease.
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82787
Test Components

​ IgG4, Ig Subclasses

Ordering Applications
Ordering Application Description

​Cerner
​IgG4, Immunoglobulin Subclasses, Serum (IGGS4)​

If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Serum Separator Tube (SST) ​Red Top Tube (RTT) ​1 mL ​0.5 mL
Collection Processing

​Fasting preferred but not required.

Centrifuge and aliquot serum into a plastic vial.

Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerate (preferred) ​14 days
​Ambient ​14 days
​Frozen ​14 days
Rejection Criteria
Gross Lipemia and gross hemolysis.
Interference
Elevations in serum IgG4 concentrations are not specific to IgG4-related disease; they are also found in disorders such as multicentric Castleman disease, allergic disorders, Churg-Strauss syndrome, sarcoidosis, and a large number of other conditions.
Useful For
Supporting the diagnosis of IgG4-related disease.

This test only quantitates the IgG4 protein. If quantitation of all IgG subclass types is desired, order IGGS / IgG Subclasses, Serum.
Test Components

​ IgG4, Ig Subclasses

Reference Range Information
0-<5 months: < or =19.8 mg/dL
5-<9 months: < or =20.8 mg/dL
9-<15 months: < or =22.0 mg/dL
15-<24 months: < or =23.0 mg/dL
2-<4 years:< or =49.1 mg/dL
4-<7 years: < or = 81.9 mg/dL
7-<10 years: 1.0-108.7 mg/dL
10-<13 years: 1.0-121.9 mg/dL
13-<16 years: < or =121.7 mg/dL
16-<18 years: < or = 111.0 mg/dL
> or =18 years: 2.4-121.0 mg/dL
Interpretation
Elevated concentration of IgG4 is consistent with, but not diagnostic of, IgG4-related disease.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories​ ​Monday through Friday 1-2 days ​Turbidimetry
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​82787
For most current information refer to the Marshfield Laboratory online reference manual.