Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jogeet Singh Sekhon, M.D. [2] Synonyms and keywords:IgM deficiency OverviewImmunoglobulin M deficiency is said to be present when the levels of IgM in serum are <40mg/dl while the levels of all other immunoglobulins are within normal range. IgM deficiency was first noted in 1969 by Roy- Chawdhary from a jejunal biopsy. It is of 2 types primary and secondary IgM deficiency. IgM deficiency can occur due to a defect in B cells or T cells. IgM deficiency can lead to chronic infections, development of autoimmune disease and neoplastic diseases. IgM deficiency cab be caused in autoimmune conditions and it can itself lead to the development of autoimmune conditions. IgM deficiency can be differentiated from other immunoglobuiln deficiencies by measuring the levels of all the immunoglobulins.The incidence/prevalence of IgM deficiency is approximately 100-2000 per 100,000 individuals worldwide. The patients usually present with chronic or recurrent infections. Signs and symptoms of chronic lung disease, chronic ear and chronic sinus infections may be present. Historical Perspective
ClassificationThere is no established system for the classification of IgM deficiency[2].However, it may present as 2 types:
Pathophysiology
CausesThe exact cause of IgM deficiency is not known.
Differentiating IgM deficiency from Other Diseases
Epidemiology and Demographics
Risk FactorsThere are no established risk factors for IgM deficiency but it occurs more commonly in[17][18]:
Screening
Natural History, Complications, and Prognosis
DiagnosisDiagnostic Study of ChoiceThe diagnosis of IgM deficiency is made by measuring serum IgM levels[24].
History and Symptoms
Symptoms
Physical Examination
Laboratory Findings
ElectrocardiogramThere are no ECG findings associated with IgM defiicency. X-rayThere are no specific findings for IgM deficiency on x ray but signs of lung disease may be present[31].
Echocardiography or UltrasoundThere are no echocardiography/ultrasound findings associated with IgM deficiency CT scan
MRIThere are no MRI findings associated with IgM deficiency. However, signs of chronic lung disease or chronic sinsuitis may be present. Other Imaging FindingsThere are no other imaging findings associated with IgM deficiency. Other Diagnostic StudiesThere are no other diagnostic studies associated with IgM deficiency. TreatmentMedical Therapy
SurgerySurgical intervention is not recommended for the management of IgM deficiency. Primary PreventionThere are no established measures for the primary prevention of IgM deficiency. Secondary Prevention
References
What causes a low IgM?Other causes of decreased levels of serum IgM (i.e., secondary IgM deficiency) are episodes of infection, thymic hypoplasia, celiac disease, autoimmune disease, and certain adult malignancies; and other PIDs (Wiskott-Aldrich syndrome, DOCK8 deficiency, ataxia-telangiectasia, CVID, and XLA, in combination with IgG and ...
Can low IgM be treated?Medical Care. Replacement of IgM is not an option, as IgM is not a significant component of therapeutic preparations of intravenous immunoglobulin. However, defective antigen-specific IgG responses have been demonstrated in some patients. For such patients, intravenous immunoglobulin (IVIG) replacement may be an option ...
Is IgM deficiency serious?Selective IgM deficiency is more common than previously recognized and is likely a heterogeneous disorder. Patients with SIGMD may be asymptomatic; however, commonly present with chronic and recurrent infections; some of them could be serious and life threatening.
What do IgM levels indicate?Immunoglobulin M (IgM): Found mainly in blood and lymph fluid, this is the first antibody the body makes when it fights a new infection. Immunoglobulin E (IgE): Normally found in small amounts in the blood. There may be higher amounts when the body overreacts to allergens or is fighting an infection from a parasite.
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