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Is There a Clinical Significance of Very Low Serum Immunoglobulin E Level?

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Abstract

Purpose

High serum immunoglobulin (Ig) E levels are associated with allergies, parasitic infections, and some immune deficiencies; however, the potential effects and clinical implications of low IgE levels on the human immune system are not well-known. This study aims to determine the disorders accompanying very low IgE levels in children and adults.

Methods

The patients whose IgE levels were determined between January 2015 and September 2020 were analyzed, and the patients with an IgE level < 2 IU/mL were included in this study. Demographic data, immunoglobulin levels, autoantibody results, and the diagnoses of the patients were noted from the electronic recording system of the hospital.

Result

The IgE levels were measured in 34,809 patients (21,875 children, 12,934 adults), and 130 patients had IgE levels < 2 IU/mL. Fifty-seven patients were children (0.26%); 73 were adults (0.56%). There was a malignant disease in 34 (9 of them children) (26%), autoimmune diseases in 20 (3 of them children) (15.4%), and immunodeficiency in 17 (14 of them children) (13.1%) of the patients. The most common reasons were other diseases, immunodeficiency and malignancy in children, and malignancy, autoimmune disorders, and other diseases in the adults, in rank order. The IgE level did not show any correlation with the levels of other immunoglobulins.

Conclusion

Although rare, a low IgE level has been shown to accompany malignancies, autoimmune disorders, and immune deficiencies. Patients with very low IgE levels should be carefully monitored for systemic disorders.

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Data Availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

Abbreviations

Ig:

Immunoglobulin

IU/mL:

International units milliliter

USA:

United States of America

CVID:

Common variable immunodeficiency

EAACI:

European Academy of Allergy and Clinical Immunology

DEU:

Dokuz Eylul University Faculty of Medicine

ANA:

Anti-nuclear antibody

Anti dsDNA:

Anti-double stranded deoxyribonucleic acid antibodies

ENA:

Extractable nuclear antigens

Anti TPO:

Anti-thyroid peroxidase

Anti TG:

Anti-thyroglobulin

ICD-10:

The International Disease Classification 10

IEI:

Inborn error of immunity

CLL:

Chronic lymphoid leukemia

SLE:

Systemic lupus erythematosus

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Authors and Affiliations

  1. Department of Pediatric Allergy and Clinical Immunology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Serdar Al, Suna Asilsoy, Nevin Uzuner, Gizem Atakul, Özge Atay, Özge Kangallı & Özkan Karaman

  2. Department of Pediatric Hematology and Oncology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey

    Işık Odaman Al

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  1. Serdar Al
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  2. Suna Asilsoy
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  4. Gizem Atakul
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Contributions

All authors contributed to this study’s conception and design. Material preparation, data collection, and analysis were performed by Serdar Al, Gizem Atakul, Özge Atay, Özge Kangallı, Işık Odaman Al, Suna Asilsoy, Nevin Uzuner, and Özkan Karaman. The first draft of the manuscript was written by Serdar Al and Suna Asilsoy, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Serdar Al.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethics committee of Dokuz Eylul University Non-Interventional Studies Ethics Committee (Decision No: 2020/29–47).

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Not applicable.

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The authors of this manuscript attest that they have all reviewed this manuscript and have contributed in a substantively and intellectually manner to the work described.

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The authors declare no competing interests.

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Al, S., Asilsoy, S., Uzuner, N. et al. Is There a Clinical Significance of Very Low Serum Immunoglobulin E Level?. J Clin Immunol 41, 1893–1901 (2021). https://doi.org/10.1007/s10875-021-01127-y

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  • DOI: https://doi.org/10.1007/s10875-021-01127-y

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