Elevated total serum IgE in nonatopic patients with aspirin-exacerbated respiratory disease
Elevated total serum IgE in nonatopic patients with aspirin-exacerbated respiratory disease
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DOI：
10.2500/ajra.2014.28.4054
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发表时间：
2014-07-01
影响因子：
2.6
通讯作者：
Laidlaw, Tanya M.
中科院分区：
文献类型：
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作者：
Johns, Christina B.;Laidlaw, Tanya M.
工作背景：阿司匹林加重的呼吸道疾病（AERD），也被称为Samter三联征，其特征是哮喘、复发性鼻息肉以及对阿司匹林和其他非甾体抗炎药的过敏样反应，尽管它不是真正的免疫球蛋白E（IgE）介导的过敏。特应性虽然在AERD患者中很常见，但不是该疾病的特征。最近，我们观察到一个AERD患者亚组，他们没有过敏史，但血清总IgE异常升高，这一现象在哮喘患者中已观察到，但尚未进一步探讨。我们试图探讨这一现象，血清总IgE升高的过敏反应的情况下，在一个子集的AERD患者。方法：患者被诊断为AERD与口服阿司匹林的挑战，在布里格姆妇女医院过敏和诊所。特应性被定义为对至少一种常见的空气过敏原的阳性检测结果。血清总IgE升高定义为IgE>100 IU/mL.Results：我们提出了6例AERD患者，血清总IgE升高，无任何明确的特应性。这些患者的血清总IgE范围为110 - 1760 IU/mL。这些患者的平均血液嗜酸性粒细胞水平没有显着不同的AERD患者的整个队列includedinthestudy.Conclusion：在AERD患者的一个子集，我们观察到升高的血清总IgE，即使特应性不存在。为了更好地了解这种疾病，这种现象的原因和临床相关性值得进一步探讨。
Background: Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad, is characterized by asthma, recurrent nasal polyps, and by allergic-like reactions to aspirin and other nonsteroidal anti-inflammatory drugs, although it is not a true immunoglobulin E (IgE)-mediated allergy. Atopy, although common in patients with AERD, is not a characteristic of the disease. Recently, we have observed a subgroup of patients with AERD who have no history of atopy but have abnormally elevated total serum IgE, a phenomenon that has been observed in patients with asthma but has not been further explored. We sought to explore this phenomenon of elevated total serum IgE in the absence of atopy in a subset of patients with AERD.Methods: Patients were diagnosed with AERD with an oral aspirin challenge at the Brigham and Women's Hospital Allergy and Clinics. Atopy was defined as a positive test result to at least one of the common aeroallergens. Elevated total serum IgE was defined as IgE of >100 IU/mL.Results: We present six patients with AERD and elevated total serum IgE in the absence of any clear atopy. Total serum IgE in these patients ranged from 110 to 1760 IU/mL. Mean blood eosinophil levels for these patients were not significantly different from those of the entire cohort of patients with AERD included in the study.Conclusion: In a subset of patients with AERD, we observed elevated total serum IgE even when atopy was not present. To better understand the disease, the cause and clinical relevance of this phenomenon deserves further exploration.