eMedicine Specialties > Allergy and Immunology > Immunodeficiencies

Immunoglobulin D Deficiency: Differential Diagnoses & Workup

Author: Donald A Dibbern Jr, MD, Consulting Staff (Allergist), Providence St Vincent Medical Center
Coauthor(s): John M Routes, MD, Professor of Pediatrics, Medical College of Wisconsin; Chief, Section of Allergy and Clinical Immunology, Department of Pediatrics, Children's Hospital of Wisconsin
Contributor Information and Disclosures

Updated: Aug 3, 2007

Differential Diagnoses

Hypogammaglobulinemia
Immunoglobulin A Deficiency

Other Problems to Be Considered

Agammaglobulinemia
Common variable immunodeficiency
Severe combined immunodeficiency
Hyperimmunoglobulin M syndrome
Other humoral immunodeficiencies

Workup

Laboratory Studies

  • Measure all classes of quantitative immunoglobulin levels (eg, immunoglobulin A [IgA], immunoglobulin G [IgG], IgM, immunoglobulin E). However, quantification of the IgG subclass is usually not necessary. Measuring these levels helps exclude a more extensive humoral immunodeficiency (eg, common variable immunodeficiency, IgA deficiency); low levels of IgD may be associated with the presence of other immune disorders.12,13
  • Consider screening laboratory testing for complement disorders (eg, CH50), as well.14

Imaging Studies

  • Imaging studies are not routinely required for patients with isolated IgD deficiency.

Other Tests

  • Other tests are not routinely required for patients with isolated IgD deficiency.

Procedures

  • Procedures are not routinely required for patients with isolated IgD deficiency.

More on Immunoglobulin D Deficiency

Overview: Immunoglobulin D Deficiency
Differential Diagnoses & Workup: Immunoglobulin D Deficiency
Treatment & Medication: Immunoglobulin D Deficiency
Follow-up: Immunoglobulin D Deficiency
References
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References

  1. Levan-Petit I, Lelievre E, Barra A, et al. Th2 cytokine dependence of IgD production by normal human B cells. Int Immunol. 1999;11:1819-1828.

  2. Lutz C, Ledermann B, Kosco-Vilbois MH, et al. IgD can largely substitute for loss of IgM function in B cells. Nature. 1998;393 (6687):797-801.

  3. Dunnette SL, Gleich GJ, Weinshilboum RM. Inheritance of low serum immunoglobulin D. J Clin Invest. Aug 1978;62(2):248-55. [Medline].

  4. Fraser PA, Schur PH. Hypoimmunoglobulinemia D: frequency, family studies, and association with HLA. Clin Immunol Immunopathol. Apr 1981;19(1):67-74. [Medline].

  5. Calvo B, Castano L, Marcus-Bagley D, et al. The [HLA-B18, F1C30, DR3] conserved extended haplotype carries a susceptibility gene for IgD deficiency. J Clin Immunol. May 2000;20(3):216-20. [Medline].

  6. Alper CA, Marcus-Bagley D, Awdeh Z, et al. Prospective analysis suggests susceptibility genes for deficiencies of IgA and several other immunoglobulins on the [HLA-B8, SC01, DR3] conserved extended haplotype. Tissue Antigens. Sep 2000;56(3):207-16. [Medline].

  7. Sanal O, Ersoy F, Tezcan I, et al. Serum IgD concentrations in immunodeficiency diseases. Turk J Pediatr. Jul-Sep 1990;32(3):175-82. [Medline].

  8. Mosedale DE, Sandhu MS, Luan J, Goodall M, Grainger DJ. A new sensitive and specific enzyme-linked immunosorbent assay for IgD. J Immunol Methods. 2006;313(1-2):74-80. [Medline].

  9. Litzman J, Ward AM, Wild G, et al. Serum IgD levels in children under investigation for and with defined immunodeficiency. Int Arch Allergy Immunol. Sep 1997;114(1):54-8. [Medline].

  10. Haraldsson A, Weemaes CM, Jonasdottir S, et al. Serum immunoglobulin D in infants and children. Scand J Immunol. Apr 2000;51(4):415-8. [Medline].

  11. Josephs SH, Buckley RH. Serum IgD concentrations in normal infants, children, and adults and in patients with elevated IgE. J Pediatr. Mar 1980;96(3 Pt 1):417-20. [Medline].

  12. Buckley RH, Fiscus SA. Serum IgD and IgE concentrations in immunodeficiency diseases. J Clin Invest. Jan 1975;55(1):157-65. [Medline].

  13. de Laat PC, Weemaes CM, Bakkeren JA. Immunoglobulin levels during follow-up of children with selective IgA deficiency. Scand J Immunol. Jun 1992;35(6):719-25. [Medline].

  14. Alper CA, Xu J, Cosmopoulos K, et al. Immunoglobulin deficiencies and susceptibility to infection among homozygotes and heterozygotes for C2 deficiency. J Clin Immunol. Jul 2003;23(4):297-305. [Medline].

  15. Lee SK, Metrakos JD, Tanaka KR, et al. Genetic influence on serum IgD levels. Pediatr Res. Jan 1980;14(1):60-3. [Medline].

  16. Levan-Petit I, Cardonna J, Garcia M, et al. Sensitive ELISA for human immunoglobulin D measurement in neonate, infant, and adult sera. Clin Chem. Jun 2000;46(6 Pt 1):876-8. [Medline].

  17. Vladutiu AO. Immunoglobulin D: properties, measurement, and clinical relevance. Clin Diagn Lab Immunol. Mar 2000;7(2):131-40. [Medline].

  18. Vladutiu AO, Netto D. Is quantitation of serum IgD clinically useful? [letter]. Clin Chem. Jun 1982;28(6):1409-10. [Medline].

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Further Reading

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Keywords

IgD deficiency, immunodeficiency syndrome, hypoimmunoglobulinemia D, hypogammaglobulinemia D, dysimmunoglobulinemia D, dysgammaglobulinemia D, selective IgD deficiency, common variable immunodeficiency

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Contributor Information and Disclosures

Author

Donald A Dibbern Jr, MD, Consulting Staff (Allergist), Providence St Vincent Medical Center
Donald A Dibbern Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Allergy Asthma and Immunology, American Medical Writers Association, and Oregon Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

John M Routes, MD, Professor of Pediatrics, Medical College of Wisconsin; Chief, Section of Allergy and Clinical Immunology, Department of Pediatrics, Children's Hospital of Wisconsin
John M Routes, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Microbiology, American Society for Virology, Clinical Immunology Society, and Federation of American Societies for Experimental Biology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Michael R Simon, MD, MA, Clinical Professor Emeritus, Departments of Internal Medicine and Pediatrics, Wayne State University School of Medicine; Adjunct Staff, Division of Allergy and Immunology, Department of Internal Medicine, William Beaumont Hospital
Michael R Simon, MD, MA is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Allergy Asthma and Immunology, American College of Physicians, American Federation for Medical Research, Michigan State Medical Society, Royal College of Physicians and Surgeons of Canada, and Society for Experimental Biology and Medicine
Disclosure: Secretory IgA, Inc. Ownership interest Board membership

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michael A Kaliner, MD, Clinical Professor of Medicine, George Washington University School of Medicine; Chief, Section of Allergy and Immunology, Washington Hospital Center; Medical Director, Institute for Asthma and Allergy
Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, and Association of American Physicians
Disclosure: Nothing to disclose.

 
 
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