TOPLINE:

Over a quarter of patients with common variable immunodeficiency (CVID) had allergy or hypersensitivity reactions and higher immunoglobulin (Ig)E levels than patients without allergies, but overall IgE levels were low. Low IgE levels were linked to severe disease phenotypes.

METHODOLOGY:

• Researchers enrolled 60 adult Italian patients with CVID (mean age at diagnosis, 42 years; 65% female) between 2023 and 2024 to assess the prevalence of allergic diseases and whether serum IgE levels were related to clinical patterns.
• They assessed the levels of total and specific IgE, serum IgA, and other Ig classes, performed skin prick tests when indicated, and recorded allergy-focused clinical histories.
• Patients were grouped by the presence or absence of allergic diseases and by clinical phenotypes such as lymphoproliferative and granulomatous disease.
• Patients with IgE levels < 2.5 kU/L were considered IgE-deficient.

TAKEAWAY:

• Overall, 26.6% of patients with CVID had allergy and/or hypersensitivity reactions. Of them, 56.25% had allergic rhinitis, 37.5% had drug hypersensitivity reactions (mostly suspected), and 12.5% had asthma.
• Patients with allergic diseases or hypersensitivity reactions had IgE levels 8.9 kU/L higher than those without such conditions (P = .006); 65.0% of patients with CVID were IgE-deficient.
• Serum IgE levels correlated strongly with IgA levels (Spearman rho, 0.706; P ≤ .001), with 82% of patients deficient in IgE levels having IgA levels < 7 mg/dL.
• All patients with lymphoproliferative or granulomatous disease were deficient in IgE. IgE levels predicted these phenotypes with notable accuracy.

IN PRACTICE:

“[Our] findings confirm that allergic diseases are prevalent among CVID patients, with allergic rhinitis being the most common. Despite lower IgE levels in CVID patients compared with the general population, those with respiratory allergies exhibited relatively higher IgE values, highlighting the interplay between immune dysregulation and allergen exposure,” the authors of the study wrote.

SOURCE:

Maria Giovanna Danieli, MD, SOS Immunologia delle Malattie Rare e dei Trapianti, Ancona, Italy, was the corresponding author of the study, which was published online on March 17 in Scandinavian Journal of Immunology.

LIMITATIONS:

The study had a small sample from a single center, which limited statistical power and generalizability. Allergy results relied on few confirmed IgE-mediated cases and some untested suspected drug reactions. The cross-sectional design lacked follow-up, thus preventing causal inferences or validation of IgE as a prognostic marker.

DISCLOSURES:

The authors reported receiving no source of funding and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.