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Implementing calculated globulin screening for immunodeficiencies: The benefits and challenges
Stephen Jolles1, Cecilia Poli2, Nicholas L Rider3
1Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK.
Journal of Human Immunity
|July 17, 2026
Summary
Calculated globulin (CG) offers a cost-effective screening method for immunodeficiencies. Implementing CG can expedite diagnosis, improving patient outcomes and reducing healthcare burdens.
Area of Science:
- Clinical Biochemistry
- Immunology
- Diagnostic Medicine
Background:
- Diagnostic delays for primary and secondary immunodeficiencies negatively impact patient quality of life, morbidity, and mortality.
- There is a need for pragmatic, cost-effective diagnostic methodologies.
Purpose of the Study:
- To review the utility of calculated globulin (CG) as a screening tool for immunodeficiencies.
- To propose a workflow for implementing CG screening in clinical practice.
Main Methods:
- Literature review of studies correlating calculated globulin with immunoglobulin levels.
- Development of a clinical implementation workflow for CG screening.
- Discussion of AI integration and challenges in CG screening.
Main Results:
- Calculated globulin (CG) is an inexpensive and routinely performed proxy for immunoglobulin levels.
- A workflow for CG implementation, including laboratory reporting and AI integration, can expedite diagnoses.
Conclusions:
- Calculated globulin (CG) shows promise as a simple, unbiased screening tool for immunodeficiencies.
- Successful implementation requires collaboration and established age-specific CG cutoffs.
- Broader adoption of CG screening can improve early diagnosis and patient care.
