Abstract
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.