Total serum IgE: Adult reference values in Valencia (1981-2004). Usefulness in the diagnosis of allergic asthma and rhinitis

Campos, André; Reyes, Jheremy; Blanquer, Amando; Liñares, Tania; Torres, Máximo Vento

doi:10.1016/s0301-0546(05)73247-x

Cited by 14 publications

(13 citation statements)

References 9 publications

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“…This value was based on the protocol adopted by our biochemistry laboratory at King Abdulaziz Hospital, but no study has so far investigated this cut-off level. The cut-off is slightly higher than that published previously for IgE, notably the cut-off of 183 kU/L by Campos et al [ 20 ] and 169 kU/L by Carosso et al [ 21 ]. However, the normal range of total IgE can vary between ethnic groups, and those in the Middle East tend to have higher levels of circulating IgE than western populations [ 21 , 22 ].…”

Section: Discussioncontrasting

confidence: 61%

Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia

Al-Mughales

2016

Journal of Immunology Research

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Objective. To assess the diagnostic significance of total IgE in foods, inhalant, and multiple allergies. Methods. Retrospective review of the laboratory records of patients who presented with clinical suspicion of food or inhalant allergy between January 2013 and December 2014. Total IgE level was defined as positive for a value >195 kU/L; and diagnosis was confirmed by the detection of specific IgE (golden standard) for at least one food or inhalant allergen and at least two allergens in multiple allergies. Results. A total of 1893 (male ratio = 0.68, mean age = 39.0 ± 19.2 years) patients were included. Total IgE had comparable sensitivity (55.8% versus 59.6%) and specificity (83.9% versus 84.4%) in food versus inhalant allergy, respectively, but a superior PPV in inhalant allergy (79.1% versus 54.4%). ROC curve analysis showed a better diagnostic value in inhalant allergies (AUC = 0.817 (95% CI = 0.796–0.837) versus 0.770 (95% CI = 0.707–0.833)). In multiple allergies, total IgE had a relatively good sensitivity (78.6%), while negative IgE testing (<195 kU/L) predicted the absence of multiple allergies with 91.5% certitude. Conclusion. Total IgE assay is not efficient as a diagnostic test for foods, inhalant, or multiple allergies. The best strategy should refer to specific IgE testing guided by a comprehensive atopic history.

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Section: Discussioncontrasting

confidence: 61%

Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia

Al-Mughales

2016

Journal of Immunology Research

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“…The majority of reference values of total IgE levels published to date refer to the upper 95% CI of total IgE in non-atopic or non-allergic subjects [ 2 , 3 , 11 , 12 , 13 ]. However, the wide overlap of total IgE levels between atopic and nonatopic subjects leads to unsatisfactory performance of using the traditional upper 95% CI as cutoffs owing to their low diagnostic sensitivities, as demonstrated in the current and previous studies [ 2 , 11 , 12 , 13 ]. As shown in the present study, four in ten (38.8%) of atopic subjects have total IgE levels below the upper 95% CI of total IgE in non-atopic subjects (164.3 kU/L), and as such, will be misclassified as normal.…”

Section: Discussionmentioning

confidence: 99%

“…Thus the reliability of total IgE as a diagnostic criterion of allergic diseases depends on the establishment of valid reference values for particular populations. Although several studies have been conducted on Western children to establish the reference values of serum total IgE levels and determine its application as a diagnostic test for allergic disease [ 2 , 3 , 4 , 11 , 12 , 13 , 14 ], few data are available in Asian children.…”

Section: Introductionmentioning

confidence: 99%

Total Serum IgE in a Population-Based Study of Asian Children in Taiwan: Reference Value and Significance in the Diagnosis of Allergy

Chang

Tsai

et al. 2013

PLoS ONE

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BackgroundTotal serum immunoglobulin (IgE) test is usually performed to aid in the diagnosis of allergic diseases, but its reference values may vary among people of different ethnic backgrounds.ObjectivesTo establish reference values of total IgE in Asian children and to assess their significance in the diagnosis of atopy and allergic diseases.Study design1321 Asian children aged 5-18 years in the Prediction of Allergies in Taiwanese CHildren (PATCH) study, a population-based cohort, were evaluated for total and specific IgE by ImmunoCAP and Phadiatop Infant, respectively.ResultsMale, atopy, allergic diseases, recent symptoms of upper respiratory infection, and lower FEV1/FVC, were associated with higher total IgE levels in univariate analyses. Multivariate analysis revealed that atopy was the single most important determinant explaining 66.1% of the variability of total IgE levels in this population. The area under the receiver-operator characteristic (ROC) curve of total IgE for diagnosing atopy, asthma, rhinitis, and eczema were 0.92, 0.72, 0.70, and 0.70, respectively. The sensitivity, specificity, and positive and negative predictive values of total IgE at the optimal cutoff of 77.7 kU/L on the ROC curve for diagnosing atopy were 82.3%, 87.1%, 89.5%, and 78.6%, respectively. The corresponding values using the upper 95% CI of total IgE (164.3 kU/L) in non-atopic children were 61.2%, 95.0%, 94.3%, and 64.6%, respectively; whereas a customary cutoff (100 kU/L) provided accuracy between that of the aforementioned two cutoffs. Total IgE at the cutoff of 77.7 kU/L provided modest sensitivity and specificity (49.0%-78.3%) for diagnosing allergic diseases, but had high negative predictive values (84.2%-97.9%).ConclusionsTotal serum IgE discriminates Asian children with and without atopy independent of allergic symptoms, with an optimal cutoff of 77.7 kU/L. The study confirms the insufficient diagnostic accuracy of total IgE alone to detect allergic diseases, but low total IgE levels may help exclude allergic diseases.

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“…Therefore, there has been considerable interest in the validity of total IgE level as diagnostic tool for allergy. However, the diagnostic value of total IgE levels seems to be limited, although many patients with allergic disorders have elevated levels of total IgE (121719272829303132). A Taiwanese study calculated that the cut-off value of total IgE for discriminating between an atopy and non-atopy group was 77.7 kU/L, with sensitivity and specificity of 82.3% and 87.1%, respectively (17).…”

Section: Discussionmentioning

confidence: 99%

Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

et al. 2017

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The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12–13 years and parents of children aged 6–7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5–4,523.1) in 3,753 children aged 6–7 years and 94.7 kU/L (range: 1.5–3,000.0) in 3,930 children aged 12–13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6–7 year-olds and 12–13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.

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Total serum IgE: Adult reference values in Valencia (1981-2004). Usefulness in the diagnosis of allergic asthma and rhinitis

Cited by 14 publications

References 9 publications

Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia

Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia

Total Serum IgE in a Population-Based Study of Asian Children in Taiwan: Reference Value and Significance in the Diagnosis of Allergy

Reference Values and Utility of Serum Total Immunoglobulin E for Predicting Atopy and Allergic Diseases in Korean Schoolchildren

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