Profiles of sensitization and comorbidity in asthma patients with markedly increased serum total immunoglobulin E level (>1000 kUA/L)

Abstract BackgroundImmunoglobulin E (IgE) plays an important role in asthma, but a few cases exhibited extremely high levels of serum total IgE. This study aimed to investigate the profiles of complications, severity, and sensitizations in asthma patients with serum total IgE level >1000 kUA/L.MethodsWe retrospectively analyzed 170 asthma patients with serum total IgE levels >1000 kUA/L from the in-patient database of First Affiliated Hospital of Guangzhou Medical University from January 2014 to June 2019. Available information including age, gender, body mass index (BMI), diagnosis, results of blood routine, pulmonary function, fractional exhaled nitric oxide (FeNO), induced sputum (if any), IgE (both total and specific) and medication records were analyzed. ResultsAbout 15% patients had at least one complication, and 78.82% patients were positive for at least one allergen. The top two complications were airway infections (44.71%) and rhinosinusitis (41.18%), followed by hypertension and/or cardiovascular diseases (20.59%) and COPD (12.94%). And in patients without sensitization, rhinosinusitis accounted for the highest proportion over all complications (45.83%). Serum total IgE levels did not differ among patients with different complications. Overall, mites had the highest positive rate (59.4%). In minors, the positive rates of mites (81.25% vs. 54.35%, P <0.01) and food (68.75% vs. 39.86%, P <0.01) were significantly higher than those in adults. Serum total IgE levels were positively correlated to house dust mite specific IgE levels (r=0.23, P <0.05), peripheral blood eosinophil counts (r=0.21, P <0.01) and number of confirmed sIgE positivity (r=0.19, P <0.01) and optimal scaling analysis showed that asthma severity was associated with A. fumigatus specific IgE levels. ConclusionsIn asthma patients with markedly increased serum total IgE levels (>1000 kUA/L), the most common two complications were airway infections and rhinosinusitis despite of sensitization. A. fumigatus specific IgE levels were closely associated with total IgE levels and asthma severity.