Total Serum IgE as a Parameter to Differentiate Between Intrinsic and Extrinsic Atopic Dermatitis in Children

Abstract

Atopic dermatitis (AD) has been sub-classified into extrinsic and intrinsic types according to the presence or not of allergen-specific IgE antibodies. Although total serum IgE levels are frequently elevated in AD, their potential to predict allergen-specific IgE (asIgE) has rare ly been studied. We investigated 103 children with AD and suspected allergen-specific sensitization. A thorough clinical examination, a structured medical history and total serum IgE and asIgE measurements were performed. Fifty-three male and 50 female patients, median age 35 months (range 3 months to 17 years), were recruited. Sixty-three percent of patients were asIgE positive, while 37% did not reveal such IgE antibodies; median total serum IgE levels were 224.0 kU/l (14-12,013 kU/l) and 25.2 kU/l (0-4352 kU/l), respectively. Associations of asIgE status with atopic co-morbidity and total serum IgE levels were statistically significant. At a cut-off total serum IgE level of 106 kU/l (sensitivity 68.7%; specificity 92.3%), positive and negative predicted values (93.6% and 64.3%, respectively) were determined. Clinical decision points predictive of positive asIgE results were identified in 90%, 95% and 99% of patients, respectively. Total serum IgE values were significantly associated with the asIgE status of investigated patients. However, these preliminary data warrant further large-scale investigations before total serum IgE levels can be regarded as a clinically useful parameter between patients with extrinsic atopic dermatitis and intrinsic atopic dermatitis.

Comorbidity of Vitamin A and Vitamin D Deficiency Exacerbates the Severity of Atopic Dermatitis in Children

“…Total IgE levels and eosinophil counts have long been considered important indexes for AD diagnosis, and elevated total IgE and higher eosinophil counts are commonly observed in patients affected by AD [46]. In this study, the total IgE level was significantly higher in AD patients than in HCs and positively correlated with disease severity, in accordance with previous studies [47].…”

Clinical Features and Immunological Markers of Atopic Dermatitis in Elderly Patients

“…Our findings confirmed that 21% of elderly patients had AD with low total IgE and were not allergic to common allergens. These values are slightly higher than those of other reports (5–15%), which have investigated younger populations [9,14,15]. It is possible that AD with low total IgE is more prevalent in elderly AD patients.…”

The Influence of Pregnancy and Menstruation on the Deterioration of Atopic Dermatitis Symptoms

“…The total IgE levels and the Eczema Area and Severity Index (EASI) score were examined on the hospital visit and the average values were compared between the patient groups (those who have experienced deterioration and those who have not experienced any noticeable changes). In addition, we classified the patients into those who showed low total serum IgE levels (＜200 kU/l), with the absence of associated respiratory diseases, a lack of allergen specific serum IgE antibodies and negative skin prick tests into the intrinsic AD (IAD) group 11 . We compared the difference in the prevalence of symptom aggravation in association to pregnancy or menstruation between the IAD patients and the extrinsic AD (EAD) patients.…”