Very high immunoglobulin E levels in children: when from pediatrician to immunologist?

IF 2.6 4区医学 Q2 Medicine

Minerva pediatrica Pub Date : 2024-02-01 Epub Date: 2020-08-04 DOI:10.23736/S2724-5276.20.05778-3

Funda Erol Cipe, Gonca Keskindemirci

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引用次数: 0

Abstract

Background: Total serum immunoglobulin E (IgE) is increased in many situations such as allergic diseases, primary immunodeficiencies (PID), parasitosis, infections and malignancies. When IgE levels are >1000 kU/L PIDs are suspected by pediatricians. We tried to define some clinical and laboratory parameters to distinguish PID from the others.

Methods: We evaluated 158 children between 1.7-17 years (mean: 6.6±3.4) for allergic diseases, PID, parasitosis and others. Total IgE, specific IgE, immunoglobulin levels and skin prick tests were performed to all patients. Parasite investigations, viral serological tests and detailed immunologic tests were analyzed in only patients who had suspected complaints. Hyper IgE syndrome (HIES) scoring sheet was filled out for all patients.

Results: Among all patients, 114 were diagnosed as bronchial asthma, allergic rhino-conjunctivitis or atopic dermatitis. PID diagnosis was established in totally 32 patients. Immunological evaluations were normal in 126 patients. Eleven patients were accepted as parasitosis. Median HIES score was 18 (5-44 points).

Conclusions: Pediatricians may use HIES scoring sheet when they suspect a patient with PID. If the patient has very low points, they may follow the patient. If there are about 18-20 points, they should get an opinion from an immunologist for detailed immunologic tests.

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儿童免疫球蛋白 E 水平极高：何时从儿科医生转向免疫学家？

背景：在许多情况下，如过敏性疾病、原发性免疫缺陷（PID）、寄生虫病、感染和恶性肿瘤，血清总免疫球蛋白 E（IgE）都会升高。当 IgE 水平大于 1000 kU/L 时，儿科医生会怀疑是 PID。我们试图确定一些临床和实验室参数，以便将 PID 与其他疾病区分开来：我们对 158 名 1.7-17 岁的儿童（平均：6.6±3.4）进行了过敏性疾病、PID、寄生虫病和其他疾病的评估。对所有患者进行了总 IgE、特异性 IgE、免疫球蛋白水平和皮肤点刺试验。寄生虫检查、病毒血清学检测和详细的免疫学检测仅对疑似主诉的患者进行了分析。所有患者都填写了高 IgE 综合征（HIES）评分表：结果：在所有患者中，有 114 人被诊断为支气管哮喘、过敏性鼻结膜炎或特应性皮炎。共有 32 名患者确诊为特应性皮炎。126 名患者的免疫评估结果正常。有 11 名患者被确诊为寄生虫病。HIES 评分中位数为 18 分（5-44 分）：结论：儿科医生在怀疑患者患有 PID 时可使用 HIES 评分表。结论：儿科医生在怀疑患者患有 PID 时，可使用 HIES 评分表。结论：儿科医生在怀疑患者患有 PID 时，可使用 HIES 评分表。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minerva pediatrica PEDIATRICS-

CiteScore

2.70

自引率

3.80%

发文量

审稿时长

>12 weeks

期刊介绍： Minerva Pediatrica publishes scientific papers on pediatrics, neonatology, adolescent medicine, child and adolescent psychiatry and pediatric surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.