Hyperimmunoglobulin E Syndrome (Job Syndrome) Discovered in a Patient Following Corrective Spine Surgery: Case Report and Review of the Literature

Abstract

Job syndrome is a primary immunodeficiency often associated with scoliosis. Given the implications for surgical outcome in immunodeficient patients, the diagnosis should be considered and, blood tests instituted in patients with scoliosis with any of the associated history and physical findings of Job syndrome.

Autologous nucleus pulposus primes T cells to develop into interleukin‐4‐producing effector cells: An experimental study on the autoimmune properties of nucleus pulposus

“…In initial support of this notion elevated IgE levels have been detected in a patient having recurrent disc herniation. 40 In consideration of the demonstrated pro-algesic properties of IgE, it seems likely that T H 2-derived IL-4 may potentiate local pain transmission indirectly via IgE production. Evidence revealing pro-algesic properties of IgE is mainly derived from immunization studies showing an aggravation of thermal hyperalgesic response after allergen challenge in rats being passively sensitized with IgE antibodies.…”

Hyperimmunoglobulin E syndrome with persistent vertebral osteomyelitis due to methicillin-resistant Staphylococcus aureus

“…The negative analysis for the STAT3 mutation does not rule out HIES since the sensitivity of the test is not well defined and there are other mutations known to be associated with the syndrome [6] . To the best of our knowledge, this is the second reported case of Job's syndrome with vertebral osteomyelitis [11] .…”

Spinal deformity caused by hyperimmunoglobulin E syndrome

“…11 To date, however, only one report has documented scoliosis caused by HIES, which was discovered following corrective surgery that had resulted in postoperative infection. 13 To our knowledge, the present report is the first on the surgical treatment of spinal deformity caused by HIES, which was diagnosed presurgery. Here we describe the case of a surgically treated spinal deformity caused by HIES and discuss various perioperative prophylaxes for preventing postoperative infections in patients with HIES.…”