Dr. Amy Nett: Yeah, I would just run a serum immunoglobulin panel. Whenever you look at a test on Quest or LabCorp, you can just look at the description of the test and it should tell you. You just want an immunoglobulin panel that’s going to give you levels of immunoglobulins A, E, G, and just give you total levels. And you want to see levels, yeah, generally in the middle one-third, and if below that, yeah, it could be genetic. Normally that’s IgA if it’s low.
If the markers are particularly low, you could refer. You’re asking to whom you would refer if abnormally low. Low immunoglobulins … I don’t know. You need to put this in clinical context, I think, because if I just see a low IgA, I’m not sure that it requires additional workup. I think here we kind of need to understand what the clinical picture is. Does this person have evidence of immunodeficiency? Are they getting sick all the time? Are they chronically ill? Check their viral panels. Is their immune system not handling things? It depends a little bit on the clinical picture and what you’re suspecting that would determine whom I would refer to.
Send a little more information maybe once you have the test results. Give the clinical picture and then what immunoglobulin panel actually looks like, and then we can sort of figure out where to go from there. That would be great, something to follow up on.