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Selective IgE deficiency

John Kelly Smith, MD
Guha Krishnaswamy, MD, FACP, FCCP, FACAAI, FAAAI, CC-D
Section Editor
E Richard Stiehm, MD
Deputy Editor
Anna M Feldweg, MD


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 [1].

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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Literature review current through: Nov 2017. | This topic last updated: Feb 28, 2014.
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