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Immunoglobulin E (IgE) is a type of antibody (or immunoglobulin (Ig) "isoform") that has been found only in mammals. IgE is synthesised by plasma cells . Monomers of IgE consist of two heavy chains (ε chain) and two light chains, with the ε chain containing four Ig-like constant domains (Cε1–Cε4). [ 1 ]
An IgE level greater than 2,000 IU/mL is often considered diagnostic. [17] However, patients younger than 6 months of age may have very low to non-detectable IgE levels. Eosinophilia is also a common finding with greater than 90% of patients having eosinophil elevations greater than two standard deviations above the normal mean. [ 18 ]
Hyper IgM syndrome is a rare primary immune deficiency disorders characterized by low or absent levels of serum IgG, IgA, IgE and normal or increased levels of serum IgM. [ 8 ] They are resulting from mutations in the pathway from B-cell activation to isotype class switching.
According to this system, known as the Gell and Coombs classification [6] or Gell-Coombs's classification, [7] there are four types of hypersensitivity, namely: type I, which is an Immunoglobulin E (IgE) mediated immediate reaction; type II, an antibody-mediated reaction mainly involving IgG or IgM; type III, an immune complex-mediated reaction ...
Another laboratory test is the blood test for IgE (immunoglobulin production), such as the radioallergosorbent test (RAST) or the more recent enzyme allergosorbent tests (EAST), implemented to detect high levels of allergen-specific IgE in response to particular allergens. Although blood tests are less accurate than the skin tests, they can be ...
When it is mutated, an incorrect protein is produced, so there is, at most, a trace level of functional DOCK8 protein in the cell. There are a variety of loss-of-function mutations in DOCK8 that can cause deficiency and hyperimmunoglobulin E, including frameshift mutations, nonsense mutations, microdeletions, and, most commonly, large deletions.
Most hypergammaglobulinemias are caused by an excess of immunoglobulin M (IgM), because this is the default immunoglobulin type prior to class switching. Some types of hypergammaglobulinemia are actually caused by a deficiency in the other major types of immunoglobulins, which are IgA , IgE and IgG .
Immunoglobulin (Ig) class switch recombination deficiencies are characterized by elevated serum IgM levels and a considerable deficiency in Immunoglobulins G (IgG), A (IgA) and E (IgE). As a consequence, people with HIGM have an increased susceptibility to infections. [9] [7] [10]
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