THE CLINICAL-VALUE OF TOTAL IGE MEASUREMENTS

The clinical value of total IgE measurements. When immunoglobulin E (IgE) was first identified in human sera in 1966, it appeared that it could be used to discriminate between atopic and nonatopic patients. It soon became obvious that this test could not be completely reliable, as it has been demonstrated that IgE may occur in sera of non-atopic asthmatics too, sometimes even in significant amounts. Again, low levels of total IgE may occur occasionally in patients with proven IgE-mediated disease. The measurement of total IgE as a screening test for atopy has therefore been partly replaced by Phadiatop test. But this does not mean that further IgE measurements will be insignificant, as, with increased knowledge of total IgE, this parameter remains of clinical value. Measurements of total IgE of cord blood has still to be regarded as a sensitive parameter of the eventual atopic predisposition of the newborn. Subsequent total IgE measurements have allowed the estimation of the degree of continuing allergen exposure and the efficiency of initiated allergen avoidance respectively. Again, in allergic bronchopulmonary aspergillosis total IgE measurements are most important in recognizing exacerbations of the disease and to judge the effect of corticosteroid treatment. Finally numerous diseases with disorders in T-cell mediated immunity show an unspecific augmentation of total IgE.