Relationship between extremely low total serum IgE levels and rhinosinusitis

Chronic Sinopulmonary Inflammatory Diseases in Adults with Undetectable Serum IgE in Inner-City Chicago: A Preliminary Observation

“…The results of this study contrast, however, with those reported from Tucson, AZ, an urban community located in an arid region of the southwestern US, where no physician-diagnosed asthma was reported among subjects with very low serum total IgE [12]. These data, coupled with studies reported from rural eastern Tennessee [5] and southeastern Michigan [6], suggest the presence of a distinct interplay between IgE and local environmental factors in the pathogenesis of chronic rhinosinusitis and asthma in inner-city Chicago residents. Conceivably, IgE may not be required for the development of chronic mucosal inflammation in these patients [2,10,11,18,25].…”

“…The prevalence of chronic rhinosinusitis was not reported. By contrast, Levin et al [6] detected extremely low serum total IgE levels (B2.1 IU/ mL) in 20 pregnant women residing in southeastern Michigan, with no significant difference in the prevalence of physician-diagnosed asthma in comparison to pregnant women with serum total IgE C2.1 IU/mL. However, the former group had significantly lower prevalence of physician-diagnosed rhinosinusitis.…”

“…While several studies have reported an increased prevalence of chronic sinopulmonary inflammatory diseases in patients with selective IgE deficiency, including rhinosinusitis, chronic bronchitis, and asthma, other investigators were unable to reproduce this observation [5][6][7][8][9]. For example, Smith et al [5] reported that 32 of 44 adult patients (73%) with a serum total IgE level B2.5 IU/mL in rural eastern Tennessee had physician-diagnosed asthma compared to 20% in those with a normal or an elevated serum total IgE level.…”

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…[585][586][587][588][589] An association between hypoimmunoglobulinemia and CRS has been described in the literature and multiple studies have demonstrated PID as a risk factor for the development of CRS. 15,155,[590][591][592][593][594][595][596] The association is further strengthened by other studies that show an increased incidence of RS in patients with immune dysfunction. 586,587 CVID, X-linked hypogammaglobulinemia, and several other disorders of humoral immunity are frequently referenced as contributing factors to chronic or recurrent recalcitrant RS.…”

“…155,277,585,[590][591][592]813 Certain selective Ig deficiencies may be associated with other diagnoses, such as the linkage between IgG3 deficiency and atopy, stressing the importance of an adequate assessment and treatment for allergies in these patients. 595 A systematic review of the literature for immunodeficiency treatment in CRS identified 1 randomized, double-blind cross-over trial, 2 level 2b and 3b studies each, 1 level 4 study and 6 level 5 studies as follows: Tas et al 814 performed a randomized control study using thymic hormone preparation thymostimulin (TP-1) and placebo in a crossover trial. TP-1 was proven to be effective in patients with recurrent CRS who were immunologically deficient in cell-mediated immunity.…”