Selective IgE deficiency
- John Kelly Smith, MD
John Kelly Smith, MD
- Fellow and Laureate ACP
- Emeritus Professor of Medicine
- James H Quillen College of Medicine
- East Tennessee State University
- Guha Krishnaswamy, MD, FACP, FCCP, FACAAI, FAAAI, CC-D
Guha Krishnaswamy, MD, FACP, FCCP, FACAAI, FAAAI, CC-D
- Professor of Medicine and Pediatrics
- Wake Forest University School of Medicine
INTRODUCTION AND DEFINITION
Selective immunoglobulin E (IgE) deficiency is defined as a significant decrease in the levels of IgE (<2.5 int. units/mL) in a patient whose other immunoglobulin levels, including immunoglobulin G (IgG) subclasses and immunoglobulin A (IgA) levels, are normal. It is a laboratory finding that does not necessarily equate to a clinical disorder. This topic review will present the limited information available about this subject.
The normal production of IgE and pathogenic role of IgE in allergic disease are discussed separately. (See "The humoral immune response".)
The prevalence of immunoglobulin E (IgE) deficiency depends upon the population under study. The authors measured serum IgE levels in 500 blood donors, 974 allergy/immunology clinic patients, and 155 rheumatology clinic patients, and found deficient levels in 2.6, 8.1, and 9.7 percent, respectively. IgE deficiency was selective in 0.8, 3.1, and 1.3 percent of these cohorts. Associated immunoglobulin deficiencies varied among the three populations (table 1).
The pathogenesis of selective immunoglobulin E (IgE) deficiency is not known. Defects in immunoglobulin class switching have not been conclusively demonstrated .
Related disorders — Low serum levels of IgE can accompany well-defined immune deficiency diseases, including common variable immunodeficiency, immunoglobulin G (IgG) subclass deficiencies, ataxia-telangiectasia, and Bruton's hypogammaglobulinemia [2,3]. (See "Clinical manifestations, epidemiology, and diagnosis of common variable immunodeficiency in adults" and "IgG subclass deficiency" and "Ataxia-telangiectasia".)
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- INTRODUCTION AND DEFINITION
- Related disorders
- POSSIBLE BENEFICIAL ROLES OF IgE
- Prevention and control of infection
- - Viral infections
- - Parasitic infections
- - Sinopulmonary bacterial infections
- Protection against airway disease
- Protection against autoimmune disease
- Antitumor activity
- PROPOSED CLINICAL AND LABORATORY FEATURES
- EVALUATION AND DIAGNOSIS
- SUMMARY AND RECOMMENDATIONS