Differential Diagnosis of Elevated IgE

  • Atopic disease
    • Level usually highest in AD > asthma > perennial AR > seasonal AR
    • It is theorized that non-atopic patients with elevated IgE and chronic rhinosinusitis (or asthma or AD) may have high level of sIgE to staph antigens
  • ABPA
  • CF
  • Churg-Strauss
  • Cutaneous disease
    • AD
    • Netherton syndrome
    • Bullous pemphigoid
  • Infection
    • Non-parasitic
      • EBV
      • CMV
      • HIV
      • TB
      • Leprosy
    • Parasitic infections including the following:
      • Cestodes (Echinococcus)
      • Trematodes (Schistosoma)
      • Nematodes (Ascaris, Toxocara)
      • Strongyloides
      • Ancylostoma
      • Capillaria
  • Malignancy
    • IgE myeloma, IgE monoclonal gammopathy
    • Hodgkin lymphoma
  • Immunodeficiency
    • Hyper-IgE syndrome
    • Omenn syndrome
    • Wiskott-Aldrich
    • IPEX
    • Atypical complete DiGeorge syndrome
    • Nezelof syndrome (thymic dysplasia with normal immunoglobulins)
  • Kawasaki disease
  • Nephrotic syndrome
  • Post bone marrow transplantation
  • Cigarette smoker
  • Alcoholism
  • Polyarteritis nodosa


IgE Deficiency

  • Selective IgE deficiency is defined as serum IgE <2 IU/L in a patient whose other immunoglobulin levels are normal
    • Undetectable serum total IgE may serve as a marker of immune dysregulation and autoimmunity
    • Selective IgE deficiency is associated with significantly higher prevalence of asthma, chronic sinusitis, otitis media, autoimmune, and oncological diseases in children and adults (vs. normal controls)

IgE Reference Values




References