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)

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.