Table 3 Medical conditions associated with elevated or very low/absent IgE levels
Type I hypersensitivity | Parasitosis | Cancer | Other conditions associated with elevated IgE levels | |
|---|---|---|---|---|
Elevated total and specific IgE levels | Asthma and allergic rhinitis In asthma, omalizumab treatment is dosed based on total IgE [56] Total IgE level is useful in diagnosis and monitoring of ABPA flares [44] ssIgE levels depict environmental sensitizations and could guide specific immunotherapy [57] Food allergy ssIgE levels to certain foods/molecules predict risk of anaphylaxis [60] Venom allergy ssIgE used in venom allergy diagnosis [63] Drug allergy ssIgE to penicillin may be useful to diagnose recent anaphylaxis [65] ssIgE to alpha-gal associated with cetuximab anaphylaxis [66] | Ascariasis Schistosomiasis Strongyloidiasis Geohelminthiasis Trichuriasis Enterobiasis IgE levels decrease significantly after effective anti-parasitic therapy [73] | IgE myeloma [147] Hypereosinophilic syndromes [148] | Atopic dermatitis May be associated with extremely high IgE levels [29] Immunodeficiency [83] HyperIgE syndrome, Wiskott Aldrich syndrome, Immunodysregulation polyendocrinopathy enteropathy X-linked syndrome (IPEX), Omenn syndrome, Atypical complete DiGeorge syndrome Chronic spontaneous urticaria Anti-IgE therapies support the role of IgE in pathophysiology [101, 151] IgE-mediated autoimmunity (systemic lupus [152], bullous pemphigoid [153], pemphigus vulgaris [154], autoimmune uveitis [155], rheumatoid arthritis [156], multiple sclerosis [157], autoimmune pancreatitis [158]) IgG4-related disease [87] Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) [88], Wegener’s granulomatosis [159], sarcoidosis [160] |
Type I hypersensitivity | Parasitosis | Cancer | Other conditions associated with low IgE levels | |
|---|---|---|---|---|
Very low (< 2.5 kU/mL) or absent total IgE levels | The full clinical significance of very low IgE levels is unknown May cause false negative skin tests and ssIgE results despite clinical suspicion of atopy/allergy The rates of asthma and allergic rhinitis diagnoses are lower compared with non-IgE deficient patients, however, allergy-type symptoms are not absent | It is unknown if humans with IgE deficiency would have higher rates or risk of developing parasitic infections | Higher rates and risk of malignancy compared with non-IgE deficient patients [32,33,34, 37] | Common Variable Immunodeficiency (CVID) [38] Selective IgE deficiency [162] Hyper-IgM syndrome [163] |