{"id":10049,"date":"2020-04-23T03:54:59","date_gmt":"2020-04-23T00:54:59","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/imunoglobulina-igd\/"},"modified":"2025-02-05T15:23:36","modified_gmt":"2025-02-05T13:23:36","slug":"ig-d-imunoglobulina-d","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/ig-d-imunoglobulina-d\/","title":{"rendered":"Ig D (\u0418\u043c\u043c\u0443\u043d\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d D)"},"content":{"rendered":"<p style=\"text-align: justify;\"><strong><em>\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/em><\/strong><\/p>\n<p style=\"text-align: justify;\">Imunoglobulina D (IgD) este o protein\u0103 cu mas\u0103 molecular\u0103 de 180 kDa, ce reprezint\u0103 0.25% din totalul imunoglobulinelor serice. Este o component\u0103 important\u0103 a proteinelor membranare de pe suprafa\u0163a limfocitelor B la nou-n\u0103scu\u0163i, fiind de obicei co-exprimat\u0103 cu o alt\u0103 categorie de anticorpi (IgM). Rolul IgD membranare nu este pe deplin cunoscut, dar se crede c\u0103 aceasta este implicat\u0103 \u00een modularea diferen\u0163ierii \u015fi prolifer\u0103rii clonale a limfocitelor B.<\/p>\n<p style=\"text-align: justify;\">Forma seric\u0103 este un monomer cu dou\u0103 lan\u0163uri grele din clasa delta (\u03b4) \u015fi dou\u0103 lan\u0163uri u\u015foare (k sau \u03bb), ce devine detectabil\u0103 abia dup\u0103 v\u00e2rsta de 6 luni. Concentra\u0163ia seric\u0103 a imunoglobulinei D prezint\u0103 valori crescute ca urmare a unor prolifer\u0103ri clonale \u00eenregistrate \u00een boli hepatice, infec\u0163ii acute sau cronice, afec\u0163iuni autoimune sau la nou-n\u0103scu\u0163ii cu infec\u0163ii <em>in utero<\/em>. Dozarea IgD este cel mai important test \u00een diagnosticul cazurilor rare de mielom multiplu cu proliferare monoclonal\u0103 IgD<sup>3;4;5<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Recomand\u0103ri pentru determinarea IgD<\/em><\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">diagnosticul mielomului multiplu de tip IgD;<\/li>\n<li style=\"text-align: justify;\">evaluarea imunit\u0103\u0163ii umorale<sup>2,4<\/sup><span style=\"font-size: 16px;\">.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong><em>Preg\u0103tire pacient <\/em><\/strong><em>-<\/em> \u00e0 jeun (pe nem\u00e2ncate)<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Specimen recoltat <\/em><\/strong><em>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Recipient de recoltare <\/em><\/strong><em>-<\/em> vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Prelucrare necesar\u0103 dup\u0103 recoltare <\/em><\/strong><em>-<\/em> probele suspectate a avea crioglobuline se men\u0163in la 37\u00baC; dup\u0103 ce se produce coagularea, se separ\u0103 serul prin centrifugare; probele suspectate a avea aglutinine la rece se trateaz\u0103 \u00eentr-un mod similar<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Volum prob\u0103<\/em><\/strong> \u2013 minim 0.5 mL ser<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Cauze\u00a0 de respingere a probei <\/em><\/strong><em>- <\/em>specimen intens hemolizat sau lipemic<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong>\u0422<em>tabilitate prob\u0103 <\/em><\/strong><em>-<\/em> serul separat este stabil: <em>7 zile<\/em> la temperatura camerei; <em>3 luni<\/em> la 2-8\u00b0C ; <em>6 luni<\/em> la \u2013 20\u00b0C<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Metod\u0103 <\/em><\/strong><em>- <\/em><span style=\"text-decoration: underline;\">dubl\u0103 imunodifuzie<\/span><sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Valori de referin\u0163\u0103<\/em><\/strong> \u2013 &lt;100 UI\/mL<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Limita de detec\u0163ie<\/em><\/strong> \u2013 10 UI\/mL<sup>1<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/p>\n<p style=\"text-align: justify;\">IgD monoclonal\u0103 este prezent\u0103 la 1% dintre pacien\u0163ii cu mielom. De multe ori aceste proteine se afl\u0103 \u00een concentra\u0163ii sc\u0103zute \u015fi nu au un v\u00e2rf maxim cuantificabil pe electroforeza proteinelor serice, dar cu toate acestea, prezen\u0163a lor indic\u0103 aproape \u00eentotdeauna o tulburare malign\u0103, cum ar fi mielomul sau amiloidoza primar\u0103.<\/p>\n<p style=\"text-align: justify;\">Un nivel crescut de IgD nu poate fi considerat o dovad\u0103 a\u00a0existen\u0163ei unei proteine monoclonale, pentru aceasta fiind necesare analize ulterioare care s\u0103 fac\u0103 distinc\u0163ia \u00eentre IgD poli- \u015fi monoclonal\u0103 (imunofixare).<\/p>\n<p style=\"text-align: justify;\">Concentra\u0163ii\u00a0 serice crescute al IgD au fost \u00eent\u00e2lnite \u00een lepra, tuberculoza, salmoneloza, hepatita infec\u0163ioasa, infec\u0163ii stafilococice recurente, infec\u0163ii virale, malarie, \u00eensa relevan\u0163a clinica a tuturor acestor cre\u015fteri de anticorpi specifici IgD, dac\u0103 exist\u0103, nu este cunoscut\u0103.<\/p>\n<p style=\"text-align: justify;\">Pacien\u0163ii imunodeprima\u0163i pot \u00eenregistra nivele crescute de IgD, dar, cum de cele mai \u00a0multe ori ace\u015ftia prezint\u0103 o serie de infec\u0163ii oportuniste, nu este clar dac\u0103 concentra\u0163iile IgD reflect\u0103 imunodeficien\u0163a \u00een sine sau procesul infec\u0163ios.<\/p>\n<p style=\"text-align: justify;\">La pacien\u0163ii cu boli autoimune a fost raportat un nivel seric IgD crescut, dar \u00een contextul cre\u015fterii tuturor tipurilor de anticorpi (IgG, IgA \u015fi IgM). Anticorpi antinucleari din clasa IgD au fost depista\u0163i la pacien\u0163i cu lupus eritematos sistemic, sindrom Sj\u00f6gren sau tiroidit\u0103 autoimun\u0103, iar autoanticorpi IgD s-au \u00eenregistrat la unii pacien\u0163i cu sclerodermie sau dermatit\u0103 atopic\u0103<sup>4,5<\/sup>.<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: small;\">\u00a0<\/span><strong><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">1. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">2. Laboratory Corporation of America Directory of Services and Interpretive Guide. Immunoglobulin D, Quantitative, Serum.www.labcorp.com . 2010. Ref Type: Internet Communication<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">3. Lothar Thomas. Immunoglobulins. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 452-455.<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">4. www.mayomedicallaboratories.com. Test Catalog. Immunoglobulin D (IgD), Serum. Ref Type: Internet Communication<\/span><\/div>\n<div style=\"text-align: justify;\"><span style=\"font-size: small;\">5. Vladutiu AO. Immunoglobulin D: properties, measurement, and clinical relevance. Clin Diagn Lab Immunol. 2000. 7(2):131-40.<\/span><\/div>","protected":false},"excerpt":{"rendered":"<p>\u0410\u043d\u0430\u043b\u0438\u0437 \u043d\u0430 \u0438\u043c\u043c\u0443\u043d\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d D (IgD) \u2014 \u044d\u0442\u043e \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0442\u0435\u0441\u0442, \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u043c\u044b\u0439 \u0434\u043b\u044f \u0438\u0437\u043c\u0435\u0440\u0435\u043d\u0438\u044f \u0443\u0440\u043e\u0432\u043d\u044f \u0438\u043c\u043c\u0443\u043d\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d\u0430 D \u0432 \u043a\u0440\u043e\u0432\u0438. \u0418\u043c\u043c\u0443\u043d\u043e\u0433\u043b\u043e\u0431\u0443\u043b\u0438\u043d D \u2014 \u044d\u0442\u043e \u0432\u0438\u0434 \u0430\u043d\u0442\u0438\u0442\u0435\u043b, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0443\u0435\u0442 \u0432 \u043a\u0440\u043e\u0432\u0438 \u0432 \u043d\u0435\u0431\u043e\u043b\u044c\u0448\u0438\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430\u0445 \u0438 \u0438\u0433\u0440\u0430\u0435\u0442 \u0440\u043e\u043b\u044c \u0432 \u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u0435. \u0418\u0437\u043c\u0435\u0440\u0435\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f IgD \u043c\u043e\u0436\u0435\u0442 \u043f\u043e\u043c\u043e\u0447\u044c \u0432\u044b\u044f\u0432\u0438\u0442\u044c \u0430\u043d\u043e\u043c\u0430\u043b\u0438\u0438 \u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u043e\u0442\u0432\u0435\u0442\u0430 \u0438 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u043d\u044b\u0435 \u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f.<\/p>\n<p>\u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u0434\u043b\u044f \u0438\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0430\u043d\u0430\u043b\u0438\u0437\u043e\u0432 \u043a\u0440\u043e\u0432\u0438, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u044d\u0442\u043e\u0442, \u0432\u043a\u043b\u044e\u0447\u0430\u044e\u0442:<\/p>\n<ol>\n<li>\u0418\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f: \u0410\u043d\u0430\u043b\u0438\u0437 IgD \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u043f\u043e\u043b\u0435\u0437\u0435\u043d \u0432 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0435 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u043d\u044b\u0445 \u0438\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u0439, \u0432\u043a\u043b\u044e\u0447\u0430\u044f \u043f\u0435\u0440\u0432\u0438\u0447\u043d\u044b\u0435 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u043d\u044b\u0435 \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u044b \u0438\u043b\u0438 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f. \u041f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0435 \u0438\u043b\u0438 \u043f\u043e\u043d\u0438\u0436\u0435\u043d\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f IgD \u043c\u043e\u0433\u0443\u0442 \u0443\u043a\u0430\u0437\u044b\u0432\u0430\u0442\u044c \u043d\u0430 \u043d\u0430\u043b\u0438\u0447\u0438\u0435 \u0438\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0430\u043d\u043e\u043c\u0430\u043b\u0438\u0439.<br \/>\n\u041c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u043d\u0433 \u0442\u0435\u0440\u0430\u043f\u0438\u0438: \u0423 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432, \u0443 \u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0443\u0436\u0435 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0440\u043e\u0432\u0430\u043d\u044b \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u043d\u044b\u0435 \u0438\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f, \u0440\u0435\u0433\u0443\u043b\u044f\u0440\u043d\u043e\u0435 \u043e\u0442\u0441\u043b\u0435\u0436\u0438\u0432\u0430\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f IgD \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u043f\u043e\u043b\u0435\u0437\u043d\u044b\u043c \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u0438 \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u044f \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f \u0431\u043e\u043b\u0435\u0437\u043d\u0438 \u0441\u043e \u0432\u0440\u0435\u043c\u0435\u043d\u0435\u043c.<\/li>\n<li>\u041f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0435 \u043d\u0430 \u0430\u043b\u043b\u0435\u0440\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0440\u0435\u0430\u043a\u0446\u0438\u0438: \u0412 \u043d\u0435\u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0441\u043b\u0443\u0447\u0430\u044f\u0445 \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f IgD \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u0441\u0432\u044f\u0437\u0430\u043d\u044b \u0441 \u0430\u043b\u043b\u0435\u0440\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u0440\u0435\u0430\u043a\u0446\u0438\u044f\u043c\u0438 \u0438\u043b\u0438 \u0430\u0442\u043e\u043f\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f\u043c\u0438. \u0410\u043d\u0430\u043b\u0438\u0437 IgD \u043c\u043e\u0436\u0435\u0442 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u0442\u044c\u0441\u044f \u043a\u0430\u043a \u0434\u043e\u043f\u043e\u043b\u043d\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0442\u0435\u0441\u0442 \u043f\u0440\u0438 \u043e\u0446\u0435\u043d\u043a\u0435 \u0430\u043b\u043b\u0435\u0440\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439.<\/li>\n<li>\u041a\u043e\u043d\u0442\u0440\u043e\u043b\u044c \u0432\u043e\u0441\u043f\u0430\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439: \u0423\u0440\u043e\u0432\u043d\u0438 IgD \u043c\u043e\u0433\u0443\u0442 \u0431\u044b\u0442\u044c \u0441\u0432\u044f\u0437\u0430\u043d\u044b \u0441 \u0432\u043e\u0441\u043f\u0430\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u043c\u0438 \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u0430\u043c\u0438 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0435. \u041e\u0442\u0441\u043b\u0435\u0436\u0438\u0432\u0430\u043d\u0438\u0435 \u0443\u0440\u043e\u0432\u043d\u044f IgD \u043c\u043e\u0436\u0435\u0442 \u0431\u044b\u0442\u044c \u043f\u043e\u043b\u0435\u0437\u043d\u044b\u043c \u043f\u0440\u0438 \u043e\u0446\u0435\u043d\u043a\u0435 \u0438 \u043a\u043e\u043d\u0442\u0440\u043e\u043b\u0435 \u0432\u043e\u0441\u043f\u0430\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439, \u0442\u0430\u043a\u0438\u0445 \u043a\u0430\u043a \u0440\u0435\u0432\u043c\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u044f \u0438\u043b\u0438 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