Methods: IgE (IU/mL) and IgG4 (mcg/mL) were measured by ImmunoCAP.
Results: From ages 8 to 12 months, our patient’s total IgE decreased from 61.4 to 44.1; peanut decreased from 13.6 to 11.2, and cow’s milk decreased from 3.84 to 2. She then received 12-month vaccines. Three weeks later, her IgE sharply increased from 44.1 to 75.6; her peanut IgE increased from 11.2 to 16.5, and her milk IgE increased from 2 to 5.06. She then avoided alum-containing vaccines and, by age 16 months, her IgE decreased to 51; her peanut decreased to 13.7, and her milk decreased 1.54. Despite peanut-avoidance, Arah2 IgE continued to rise while all other IgE values decreased. She began cow’s milk oral desensitization around 13 months-old. Peanut component IgG4 values exhibited minimal changes. Bosd4, Bosd5, and Bosd8 IgG4 changed minimally after vaccines; however, post-desensitization IgG4 values were remarkably higher - Bosd4 increased from 0.46 to 16, Bosd5 increased from 0.54 to 5.32, and Bosd8 increased from 0.75 to 2.94 at 16 months.
Conclusions: Alum-containing vaccines increased IgE, a phenomenon we have previously observed, whereas milk desensitization increased milk-component IgG4, a trend we have reported post-peanut OIT.