Depicting environmental sensitizations in Patients with Immunoglobulin E Deficiency
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Rebecca Forman, BA, Denisa Ferastraoaru, M.D.
RATIONALE: Patients with immunoglobulin E (IgE) deficiency (IED) (IgE<2.5 IU/mL) may present with symptoms suggestive of allergic rhinoconjunctivitis. The role of skin tests and blood work in finding sensitization to environmental allergens in patients with IED is unknown.

METHODS: This is a retrospective study using Clinical Looking Glass to identify adult patients with IED who were seen in our Allergy Clinics between 1/2010-11/2015. A chart review of these patients was performed.

RESULTS: Immunoglobulin E was measured in 2328 patients and 64 patients (2.7%) had IED. Diagnosis of rhinitis (chronic or allergic) was made in 35 /64 patients (55%), while 18/64 (28%) patients carried a diagnosis of asthma. Skin prick tests (SPT) to a battery of 18 allergens (including tree, grass, weeds, cockroach, dust mites, different types of molds, cat, dog, mouse) were performed in 26 patients with IED who had oculonasal symptoms and 7/26 (27%) had at least one positive skin prick test (in average 3.3 positive SPT per patient, +/- 1.8). Out of 19 patients with negative SPT, 12 (63%) underwent two steps of intradermal skin tests and 3 /12 patients (25%) had at least one test positive. Serum specific IgE levels to North-East environmental allergens were performed in 27 patients and were all negative.

CONCLUSIONS: A high proportion of patients with IED have oculonasal symptoms. Although serum specific IgE levels are negative because of very low total IgE levels, environmental sensitizations can be depicted through skin tests in this subgroup of patients, suggesting the presence of bound specific IgE.