Clinical Picture of Patients with the Undetectable Serum IgE and Low Serum IgE in a Retrospective Evaluation of Patients of the Opole Regional Hospital (2013-2023)
Published: 2024-08-10
Page: 112-122
Issue: 2024 - Volume 7 [Issue 1]
Alina Warmuzińska
Department of Imaging Diagnostics, Regional Hospital in Opole, Opole, Poland.
Dariusz Woszczyk
Clinical Department of Haematology, Faculty of Medicine, Haematological Oncology and Internal Medicine, Regional Hospital in Opole, University of Opole, Opole, Poland.
Sławomir Tubek *
Clinical Department of Haematology, Faculty of Medicine, Haematological Oncology and Internal Medicine, Regional Hospital in Opole, University of Opole, Opole, Poland.
*Author to whom correspondence should be addressed.
Abstract
Over the period 01/01/2013 until 31/08/2023, 13 907 total plasma IgE determinations were performed in the analytical laboratory of the Provincial Hospital in Opole.
Among these determinations, there were 377 results below 2.0 U/l (in 279 patients), with the ultra-extremely low results (<0.1 U/l), i.e. virtually undetectable, in 65 (in 44 patients).
The clinical picture of patients with the ultra-extremely low (undetectable) IgE (defined as <0.1 U/l) - group 1 and the low IgE (defined as <2.0 U/l), divided into 4 ranges - 0.1-0.5; 0.6 -1.0; 1.1-1.5; 1.6-1.9 U/l - the group 2, 3, 4 and 5 respectively - was compared.
Results: Health problems, defined as a syndrome of immune dysfunction, occurred more frequently in the groups with the ultra-low (virtually undetectable) IgE (<1.0) than in the group with the low IgE (0.1 - 1.9) level, suggesting primary immune deficiency in these patients. This is also supported by the fact that the group 1 was younger than the others combined, and at the same time ‘sicker’ than the other groups.
In this group - 97 patients had serum IgE determinations at least twice during the analysed period - in 20 patients at least one of the repeated serum IgE results was higher than 10 U/l, in the remaining ones - in 17 patients it was in the range (2-10 U/l), in the remaining 60 patients the results of repeated serum IgE determinations did not exceed 2 U/l.
Conclusions: For the purpose of talking about IgE deficiency as an indicator of a predisposition to neoplastic diseases, it would be necessary to carry out screening tests at least 3 times, in the identified age groups, e.g. every 10 years, from the age of 5 years.
This would make it possible to determine - whether the IgE deficiency is primary or secondary. Primary, i.e. originally predisposing to the development of neoplastic diseases and being a part of primary immunodeficiency, or secondary - as a symptom of ‘depletion’ of the immune system.
The incidentally detected low serum IgE needs to be verified.
Keywords: Ultralow/undetectable IgE plasma level (<0.1 U/l), extremely low IgE plasma level (<2.0 U/l), low IgE plasma level