Chapter 10


  • Total IgG, IgA and IgM concentrations are standardised using international reference preparations (CRM 470 and DA470k).
  • Initial publications of Hevylite® reference intervals were based on prototype Hevylite reagents. Subsequently, reference intervals were published using the fully validated commercial assays.
  • Users are recommended to either establish their own local Hevylite reference intervals or validate an existing reference interval.

Total immunoglobulin concentrations in normal individuals are influenced by a number of factors including age, gender and ethnic background [225][226]. In general, immunoglobulin levels are lower when young and increase into adulthood. The exception is IgG in newborn infants: placental transfer of IgG results in high neonatal serum concentrations (near adult levels) that persist for several months after birth.

Significant ethnic differences in immunoglobulin concentrations have been observed. Black Africans have higher levels of IgG and IgM but similar levels of IgA compared with Caucasian populations [227]. Gender may also influence immunoglobulin concentrations and significant differences in IgM reference intervals for males and females have been reported [228].