Case Report and a Review of Increased IgE in Patients with Transient Hypogammaglobulinemia of Infancy Who Received Immunoglobulins

Background: The coexistence of a high IgE level and transient hypogammaglobulinemia of infancy ( THI ) with atopic dermatitis (AD) is well known, but the coexistence with a marked serum IgE level ≥ 1000 IU/mL is a rare finding. Literature is scarce regarding IgE levels in patients with THI and AD after treatment with immunoglobulin (Ig). The present article is the first to describe a finding of marked IgE elevation (> 1000 IU/mL) after treatment with intravenous immunoglobulin (IVIG). This paper also reviews previous related reports and series. Case presentation and review: We reported on a female infant 8 months old, with THI and severe AD. She was treated with IVIG infusion after the failure of conventional therapy. Initially, serum levels of IgE were high, and serum levels of IgG were low. After 4 weeks of treatment with IVIG, the patient showed clinically improved AD in parallel with elevated IgG level but increased IgE level to a higher level. We also review previous results of IgE levels reported in cases with THI and AD before and after Ig therapy. The mean increment in IgE levels was 227.5 IU/mL (SD = 164.2). The review showed that the IgG is directly related to IgA and IgM in addition to IgE. Results also showed that IgA and IgM also have a direct relation with IgE. Conclusion: We report a case of marked IgE level in a THI patient with AD after IVIG treatment. Also, there were increased levels of IgA and IgM. A similar finding was observed in other reviewed cases.