Immunoglobulin M
110
MENTIONS
34
EPISODES
30
PODCASTS
Search complete. 110 mentions across 34 episodes found for "Immunoglobulin M".
Nov 4, 2026
Jeffrey AllenGUEST
If there's a family history, be worried about that diagnosis of CIDP.
Jeffrey AllenGUEST
On your lab testing, if you see a monoclonal gammopathy, dig a little deeper, especially if it's an IgM.
Jeffrey AllenGUEST
And then the treatment response is another big red flag.
Jeffrey AllenGUEST
We consider that patients that are suspected of having CIDP, if you improve after an immunotherapy, then that supports your diagnosis.
12 MINS LATER
Jeffrey AllenGUEST
I think those patients are really good candidates for something like F-cortegamide or maybe other therapies.
Jeffrey AllenGUEST
On the other hand, if you've got somebody that tolerates immunoglobulin well, they respond well, why switch them? There's probably not a good reason to switch them over to something that may well work, but their current treatment is working well already.
Jeffrey AllenGUEST
I think the other thing to keep an eye on is that the FCRNs do a great job at lowering IgG levels and presumably IgG autoantibodies, but they don't do anything to IgM.
Jeffrey AllenGUEST
They don't do anything to IgA.
Irwin RedlenerGUEST
Well, there's different kinds of antibodies.
Irwin RedlenerGUEST
So there's something called IgM, which happens as soon as you get an infection.
Irwin RedlenerGUEST
So as soon as you have a new virus or bacteria, that your body doesn't like, it produces some generalized antibodies called IgM.
Irwin RedlenerGUEST
A few weeks later, it produces a much more specific antibody to the thing that we might be talking about, like coronavirus, and that's an IgG antibody.
Irwin RedlenerGUEST
So as we get better and better at that, we're going to get more and more specific about, oh, this antibody This IgG is specific for coronavirus.
Rahul GainiHOST
Diagnosis of CIDP rests on a combination of the clinical picture and nerve conduction studies, along with labs to rely on other conditions.
Rahul GainiHOST
Serum protein electrophoresis with immunofixation and free light chains look for monoclonal gammopathies, including IgM paraprotein with anti-MAG antibodies and POEM syndrome, which can both mimic CIDP.
Rahul GainiHOST
Hemoglobin A1c, thyroid function, vitamin B12, and basic labs are standard.
Rahul GainiHOST
When clinical suspicion exists, add testing for Lyme disease, HIV, or rheumatologic conditions, such as screening within ANA.
Richard HorowitzGUEST
And I learned basically like you need a fourfold increase in titer.
Richard HorowitzGUEST
A lot of times when it's tricky about Epstein-Barr is a lot of these patients come in with hugely high IgG titers, right? It's not just IgM, it's IgG.
Richard HorowitzGUEST
But usually what I want to see is a fourfold increase in titers or preferably a PCR, a snippet of the DNA.
Richard HorowitzGUEST
I prefer that.
Richard HorowitzGUEST
I mean, looking at early antigen, looking at fourfold titers, looking at PCR and T cell testing, I think it'd be
Kent HoltorfHOST
very useful.
Kent HoltorfHOST
And also for toxoplasmosis, it seems like all the patients have very high IgG, no IgM.
Kent HoltorfHOST
What's your thought how to differentiate? You
speaker_0HOST
Right.
speaker_0HOST
The initial IgM response, followed by the more durable IgG response, takes weeks to develop and amplify in the bloodstream.
speaker_1HOST
Exactly.
speaker_1HOST
So if a patient shows up on day two of a fever after pulling a tick off their leg and you order a Lyme serology panel?
CaleHOST
So, it should be CD10 and BCL6 positive.
CaleHOST
Surface immunoglobulin is present and light chain restricted and often IgM.
CaleHOST
On flow, it's often CD38 bright and the key 67, the proliferation marker, you know, this is growing.
CaleHOST
This is, you know, killing itself by how fast it grows.
Jean DoddsGUEST
Titers work by stimulating the immune system.
Jean DoddsGUEST
The problem is that you have both immunoglobulin G, which is the antibody we talk about all the time, your long-term memory immunity, and then you have immunoglobulin M, which is your short-term five to six month immunity upon exposure to a foreign antigen.
Jean DoddsGUEST
So you're measuring IgM immunity and IgG immunity.
Jean DoddsGUEST
Now, immunoglobulins of all kinds, IgE, E as in Edward, is the one that's supposed to be allergen specific.
Jean DoddsGUEST
In other words, if you're allergic to peanut butter or peanuts or shellfish or whatever.
Christina CarewHOST
We'll do public health testing, like testing for past infection, just confirming they have past infection.
Christina CarewHOST
Do an IgM.
Christina CarewHOST
Do they have a current recirculating infection and a monocyte? And then sometimes, depending on presentation and what's showing up, we actually will even consider sending.
Christina CarewHOST
There's some external third-party clinics that test like latent analytic infection.
Lidia ParkHOST
Yeah, so the better test is the EBV specific serologies.
Lidia ParkHOST
So the presence of IgM anti-VCA or viral capsid antigen with low or negative EBNA, which is EBV nuclear antigen, is consistent with an acute EBV infection.
Lidia ParkHOST
And this is because EBNA is a late phase marker of infection and doesn't show up for weeks after infection, whereas anti-VCA presents early and peaks within two to four weeks of infection.
Tammy YauHOST
So let's talk about treatment for mono.
Krista MichenerHOST
But we see a lot of secondary immune dysfunction in people who have had chronic infections.
Krista MichenerHOST
Secondary meaning, yes, maybe you have depleted immunoglobulins, IgG or IgM, but those were more the result of a chronic infection that there was so much wear and tear on your system.
Krista MichenerHOST
That needs taken care of.
Krista MichenerHOST
So they're not looking at that.
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