Augmented Immunoglobulin E Synthesis in Primary Immunodeficiency

Abstract

In addition to evidence presented in the preceding chapters that IgE biosynthesis is increased in the atopic allergic diseases, there is increasing documentation that augmented IgE production often occurs in certain of the primary immunodeficiency disorders. The association of allergy with immunodeficiency has been suspected on clinical grounds for some time, although it seems more likely that many symptoms in immunodeficient patients thought to be allergic in nature merely mimic them, such as the “wheezing” of patients with pneumonia or the “hay fever” in others with infectious nasopharyngitis. In this regard, earlier claims of the frequent occurrence of “hay fever,” “asthma” (Goldfarb and Fudenberg, 1961), and “eczema” (Peterson et al., 1962) in agammaglobulinemic patients have not been supported by observations in larger groups of such patients, by results of skin tests for reaginic antibody, or by serum IgE concentrations, which have usually been extremely low (Figure 1 and Table 1) (Polmar et al., 1972b; Buckley and Fiscus, 1975). Similarly, the “eczema” reported in patients with ataxiatelangiectasia did not have the typical clinical features of atopic dermatitis (Reed et al., 1966), and serum IgE concentrations are uniformly very low in these patients (Polmar et al.,1972a; Buckley and Fiscus, 1975).

This work was supported in part by Asthma and Allergic Diseases Centers Grant No.P50 A112026–04. The author is the recipient of Allergic Diseases Academic Award No.K07 AI70830–05.