Minerva Pediatrica 2020 Aug 04

DOI: 10.23736/S0026-4946.20.05778-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Very high IgE levels in children: when from pediatrician to immunologist?

Funda EROL CIPE ¹ ✉, Gonca KESKINDEMIRCI ^{2, 3}

¹ Department of Pediatric Allergy-Immunology Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey; ² Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey; ³ Department of Social Pediatrics, Child Health Institute, Istanbul University Health Science Institude, Istanbul, Turkey

BACKGROUND: Total serum immunoglobulin E (IgE) is increased in many situations such as allergic diseases, primary immunodeficiencies (PID), parasitosis, infections and malignancies. When IgE levels >1000 kU/L are suspected PID by pediatricians. We tried to define some clinical and laboratory parameters to distinguish PID from the others.
METHODS: We evaluated 158 children between 1.7 - 17 years (Mean: 6.6 ±3.4) for allergic diseases, PID, parasitosis and others. Total IgE, specific IgE, immunoglobulin levels and skin prick tests were performed to all patients. Parasite investigations, viral serological tests and detailed immunologic tests were analyzed in only patients who had suspected complaints. Hyper IgE syndrome (HIES) scoring sheet was filled out for all patients.
RESULTS: Among all patients, 114 were diagnosed as bronchial asthma, allergic rhino-conjunctivitis or atopic dermatitis. PID diagnosis was established in totally 32 patients. Immunological evaluations were normal in 126 patients. Eleven patients were accepted as parasitosis. Median HIES score was 18 (5-44 points).
CONCLUSIONS: Pediatricians may use HIES scoring sheet when they suspect a patient with PID. If the patient has very low points, they may follow the patient. If there are about 18-20 points, they should get an opinion from an immunologist for detailed immunologic tests.

KEY WORDS: High IgE levels in children; IgE levels in allergy; Primary immunodeficiency