The Relationship between Low Total Serum IgE and Rhinosinusitis

Article Outline

• Copyright

RATIONALE: We examined self-reported respiratory disease in a group of women with “undetectable” total serum IgE to further elucidate previous reports of association between “IgE deficiency” and chronic rhinosinusitis.

METHODS: A geographically-based cohort of 590 pregnant women from southeastern Michigan was studied. Total serum IgE was measured using a standard assay (Pharmacia UniCAP) with a lower limit of detection of 2 IU/ml. Sera with IgE < 2.0 IU/ml were reassayed using the low IgE UniCAP protocol with a detection limit of 0.02 IU/ml.

RESULTS: Twenty patients (3.4%) were found to have undetectable serum IgE (< 2 IU/ml). Seventeen of the 19 with clinical information were reanalyzed using the low IgE protocol and all 17 had detectable IgE ranging from 0.5 to 2.1 (geometric mean = 1.2 IU/ml). Of the 8 women with one month postpartum samples, 6 continued to have low IgE (range 1.1-2.9) while 2 had significant increases in total IgE. None of the 19 with low IgE had physician-diagnosed sinusitis compared with 19.2% (107/556) of those with IgE > 2.0 (p=0.03). Physician-diagnosed asthma was also less prevalent (1/19) in the low-IgE group approaching statistical significance (p=0.15). The low IgE group reported a higher prevalence of hay fever symptoms than the rest of the cohort (36.8% vs 24.3%, p>0.05), but had less prevalent physician-diagnosed hay fever (5.3% vs 15.7% p=0.33).

CONCLUSIONS: In this geographically-selected cohort of pregnant women, IgE deficiency, as defined by IgE < 2 IU/ml, was relatively common. In contrast to previous reports, low IgE was not associated with chronic rhinosinusitis.