Nemet Shay, Elbirt Daniel, Cohen Ramon, Mahlab-Guri Keren, Bezalel-Rosenberg Shira, Asher Ilan, Rubin Limor, Talmon Aviv, Ribak Yaarit, Sergienko Ruslan, Tal Yuval, Shamriz Oded
Allergy and Clinical Immunology Unit, Faculty of Medicine, Kaplan Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Allergy and Clinical Immunology Unit, Department of Medicine, Faculty of Medicine, Hadassah Medical Organization, Hebrew University of Jerusalem, Jerusalem, Israel.
Pediatr Allergy Immunol. 2025 Apr;36(4):e70092. doi: 10.1111/pai.70092.
Immunoglobulin (Ig)E deficiency (<2.5 IU/mL) in adults is linked to higher risks of cancer and autoimmunity, but its significance in children remains unclear. This study evaluates the clinical importance of IgE deficiency in a nationwide pediatric cohort.
A retrospective, population-based study included 123,393 Israeli children tested for IgE levels between 2002 and 2022. Participants were categorized into four groups: deficient (<2.5 IU/mL), normal (2.5-100 IU/mL), high (100-1000 IU/mL), and very high (≥1000 IU/mL). Outcomes included cancer, inborn errors of immunity (IEI), and autoimmune disorders, with up to 5 years of follow-up. The data were analyzed using univariable methods and multivariable Cox regression.
Among the cohort, 2114 children (1.71%) had IgE deficiency, with a mean age of 3.73 years. Most (95.60%) were tested only once. IgE deficiency was associated with increased risks of solid tumors (HR = 2.721; 95% CI: 1.313-5.638), IEI (HR = 1.646; 95% CI: 1.095-2.474), and autoimmune disorders (HR = 1.266; 95% CI: 1.099-1.458) compared to normal IgE levels. No link was found between IgE deficiency and hematological malignancies. Selective IgM deficiency was the most common IEI associated with IgE deficiency (40%). Asthma prevalence was highest in children with very high IgE (N = 5574; 57.01%) and lowest in the normal IgE group (N = 24,171; 38.91%). The IgE-deficient group fell in the middle range (N = 903; 42.72%). In IgE-deficient children, allergic rhinitis was less common (11.26% vs. 14.09%).
IgE deficiency in children is associated with higher risks of solid tumors, autoimmune disorders, and IEI, suggesting potential immune dysregulation. Close monitoring of IgE-deficient children should be considered.
成人免疫球蛋白（Ig）E缺乏（<2.5 IU/mL）与癌症和自身免疫性疾病的较高风险相关，但其在儿童中的意义尚不清楚。本研究评估了全国儿科队列中IgE缺乏的临床重要性。
一项基于人群的回顾性研究纳入了2002年至2022年间检测IgE水平的123,393名以色列儿童。参与者被分为四组：缺乏（<2.5 IU/mL）、正常（2.5 - 100 IU/mL）、高（100 - 1000 IU/mL）和非常高（≥1000 IU/mL）。结局包括癌症、先天性免疫缺陷（IEI）和自身免疫性疾病，随访时间长达5年。数据采用单变量方法和多变量Cox回归进行分析。
在该队列中，2114名儿童（1.71%）存在IgE缺乏，平均年龄为3.73岁。大多数（95.60%）仅接受过一次检测。与正常IgE水平相比，IgE缺乏与实体瘤风险增加（HR = 2.721；95% CI：1.313 - 5.638）、IEI（HR = 1.646；95% CI：1.095 - 2.474）和自身免疫性疾病（HR = 1.266；95% CI：1.099 - 1.458）相关。未发现IgE缺乏与血液系统恶性肿瘤之间存在关联。选择性IgM缺乏是与IgE缺乏相关的最常见IEI（40%）。IgE非常高的儿童哮喘患病率最高（N = 5574；57.01%），正常IgE组最低（N = 24,171；38.91%）。IgE缺乏组处于中间范围（N = 903；42.72%）。在IgE缺乏的儿童中，过敏性鼻炎较少见（11.26%对14.09%）。
儿童IgE缺乏与实体瘤、自身免疫性疾病和IEI的较高风险相关，提示可能存在免疫失调。应考虑对IgE缺乏的儿童进行密切监测。
