Undetectable IgE association with noninfectious complications of common variable immune deficiency.

BACKGROUND

Undetectable IgE levels are a frequent feature of common variable immunodeficiency (CVID). However, not much is known regarding the role of IgE levels as a prognostic factor in patients with CVID.

OBJECTIVE

To evaluate whether undetectable IgE levels would be associated with higher risk of noninfectious complications of CVID.

METHODS

We compared clinical and laboratory outcomes in 60 patients with CVID with detectable IgE and 89 patients with CVID with undetectable IgE.

RESULTS

Undetectable IgE was associated with significantly lower IgG, IgM, and IgA concentrations. In addition, these patients had significantly lower numbers of CD4+ T cells, total B cells, plasmablasts, and reduced memory and especially switch memory B cells, but no difference in CD21low B cells. Undetectable IgE was associated with a significantly higher frequency of autoimmune cytopenias and lymphoma and trends toward higher relative frequencies of serious bacterial infections and granulomatous disease.

CONCLUSION

Undetectable IgE is a readily available biomarker that in a patient with CVID may direct clinicians to be particularly vigilant for noninfectious complications of CVID.