title: Relationship between extremely low total serum IgE levels and rhinosinusitis.
abstract: BACKGROUND
  The few studies examining clinical manifestations in adults with serum IgE levels less than 2.0 IU/mL provide conflicting information.
  
  
  OBJECTIVE
  To examine self-reported respiratory disease in women with total serum IgE levels less than 2.0 IU/mL to further elucidate previous reports of an association between IgE deficiency and chronic rhinosinusitis.
  
  
  METHODS
  In a geographically based cohort of 626 pregnant women, total serum IgE levels were measured using a standard assay with a lower limit of detection of 2.0 IU/mL. Sera with IgE levels less than 2.0 IU/mL were assayed again using a low IgE protocol with a detection limit of 0.02 IU/mL.
  
  
  RESULTS
  Twenty-one individuals (3.4%) were found to have IgE levels less than 2.0 IU/mL. On repeated assay, 20 of these individuals with available clinical data were found to have detectable IgE levels ranging from 0.5 to 2.1 IU/mL (geometric mean, 1.2 IU/mL). None of these individuals with low IgE levels had physician-diagnosed sinusitis compared with 19.3% (113/585) of those with IgE levels of 2.0 IU/mL or greater (P = .03). Physician-diagnosed asthma was also less prevalent (1/19, 5.3%) in the low IgE group compared with 20.6% in those with higher IgE levels, but this was not significant (P = .14). The low IgE group reported a higher prevalence of hay fever symptoms than the remaining cohort (31.6% vs 24.4%; P = .43) but had less physician-diagnosed hay fever (5.3% vs 15.8%; P = .34).
  
  
  CONCLUSIONS
  Low serum IgE levels were relatively common in these pregnant women. In contrast to previous studies, a low IgE level was not associated with chronic rhinosinusitis.
authors.affiliation: Section of Allergy and Immunology, Medical College of Georgia, Augusta, Georgia 30912, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Levin
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Ownby
authors.forename: Phillip H
authors.initials: PH
authors.lastname: Smith
authors.forename: Edward L
authors.initials: EL
authors.lastname: Peterson
authors.forename: L Keoki
authors.initials: LK
authors.lastname: Williams
authors.forename: Janet
authors.initials: J
authors.lastname: Ford
authors.forename: Penny
authors.initials: P
authors.lastname: Young
authors.forename: Christine C
authors.initials: CC
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001249:Asthma / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008824:Michigan / Q000453:epidemiology; D011247:Pregnancy; D012220:Rhinitis / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000097:blood / Q000453:epidemiology / Q000276:immunology; D012852:Sinusitis / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D011795:Surveys and Questionnaires
chemical_list: D007073:Immunoglobulin E