CORRELATION OF SERUM IMMUNOGLOBULIN E LEVELS WITH ASTHMA SEVERITY IN CHILDREN (2-12 YEARS) PRESENTING TO A TERTIARY CARE HOSPITAL

Main Article Content

Muhammad Athar Ahmed
Muhammad Nadeem Chohan
Kashif Abbas
Samina Shamim

Abstract

ABSTRACT

OBJECTIVE: To determine the correlation of serum IgE levels with asthma severity in children (2-12 years) presenting to Pediatric Outpatient Department, Liaquat National Hospital Karachi.

METHODS: A descriptive cross-sectional study was done at Department of Pediatric Medicine, Liaquat National Hospital, Karachi from June 2016 to December 2016. A total of 106 children with symptoms of airflow obstruction characterized by recurrent cough, difficulty in breathing and wheeze were included in this study.  The severity of asthma were classified as intermittent, mild, moderate or severe persistant asthma based on subjective experience of the patients. Blood samples for serum IgE levels were taken and serum IgE levels were estimated by automated chemiluminescence system.

RESULTS: The average age of the children was 6.38±6.0 years. In this study, intermittent asthma was observed in 24 (22.64%) cases. There were 30 (28.6%) children with mild asthma, 40 (37.74%) children with moderate asthma and severe asthma was found in 12 (11.32%) children. The mean IgE concentration was lowest in children with intermittent asthma (277.92±45.87 IU/ml), higher in children with mild persistent asthma (487.47±58.47 IU/ml) and highest in children with moderate and severe persistent asthma (688.75±52.08 and 1078.83±64.10IU/ml), respectively.  .

CONCLUSION: Our results support the hypothesis that severity of asthma is reflected by serum IgE levels in children. We found that the mean IgE concentration correlates with the severity of asthma, being highest in the patients with severe asthma and dropping down as the symptoms wane.

KEY WORDS: Asthma (MeSH); Immunoglobulin E (MeSH); IgE concentration (Non-MeSH); Bronchoconstriction (MeSH); Allergy (MeSH); Hypersensitivity (MeSH); Child (MeSH); Child, Preschool (MeSH).

Article Details

How to Cite
Ahmed, Muhammad Athar, et al. “CORRELATION OF SERUM IMMUNOGLOBULIN E LEVELS WITH ASTHMA SEVERITY IN CHILDREN (2-12 YEARS) PRESENTING TO A TERTIARY CARE HOSPITAL”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 10, no. 4, Dec. 2018, pp. 212-16, doi:10.35845/kmuj.2018.18062.
Section
Original Articles
Author Biographies

Muhammad Athar Ahmed, Department of Pediatrics, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Registrar Pediatrics

Muhammad Nadeem Chohan, Department of Pediatrics, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Pediatrics Assistant Professor

Kashif Abbas, Department of Pediatrics, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Assistant Professor Pediatrics

Samina Shamim, Department of Pediatrics, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Professor Pediatrics

References

REFERENCES:

Anupama N, Sharma MV, Nagaraja HS, Bhat MR. The serum immunoglobulin E level reflects the severity of bronchial asthma. Thai J Physiol Sci (TJPS) 2005; 18(3):35-40.

Bousquet J, Peter K, Jeffery S, William W, Busse A, Johnson M, et al. Asthma. From bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med 2000 May;161(5):1720-45. DOI: 10.1164/ajrccm.161.5.9903102.

Blumenthal MN. The role of genetics in the development of asthma and atopy. Curr Opin Allergy Clin Immunol 2005 Apr;5(2):141-5. DOI: 10.1097/01.all.0000162306.12728.c2.

Sears MR, Burrows B, Flannery EM, Herbison GP, Hewitt CJ, Holdway MD. Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. N Eng J Med 1991 Oct 10;325(15):1067-71. DOI: 10.1056/NEJM199110103251504.

Burrows B, Sears MR, Flannery EM, Herbison GP, Holdway MD, Silva PA. Relation of the course of bronchial responsiveness from age 9 to age 15 to allergy. Am J Respir Crit Care Med 1995 Oct;152(4 Pt 1):1302-8. DOI: 10.1164/ajrccm.152.4.7551386.

Sherrill DL, Stein R, Halonen M, Holberg CJ, Wright A, Martinez FD. Total serum IgE and its association with asthma symptoms and allergic sensitization among children. J Allergy Clin Immunol 1999 Jul;104(1):28-36. DOI: 10.1016/S0091-6749(99)70110-7.

Hayes D Jr, Kraman SS. The physiologic basis of spirometry. Respir Care 2009 Dec;54(12):1717-26.

Jamalvi SW, Raza SJ, Naz F, Shamim S, Jamalvi SM. Management of acute asthma in children using metered dose inhaler and small volume nebulizer. J Pak Med Assoc 2006 Dec;56(12):595-9.

Dati F, Ringel KP. Reference values for serum IgE in healthy non atopic children and adult. Clin Chem. 1982;28(7):1556.

Siroux V, Oryszczyn MP, Paty E, Kauffmann F, Pison C, Vervloet D, et al. Relationships of allergic sensitization, total immunoglobulin E and blood eosinophils to asthma severity in children of the EGEA Study. Clin Exp Allergy 2003 Jun;33(6):746-51. DOI: 10.1046/j.1365-2222.2003.01674.x

Sandeep T, Roopakala S, Rayappa C, Delphin W, Chandrashekara S, Rao M. Evaluation of serum immunoglobulin E levels in bronchial asthma. Lung India 2010 Jul;27(3):138-40. DOI: 10.4103/0970-2113.68312.

Kovac K, Dodig S, Tjesić-Drinković D, Raos M. Correlation between asthma severity and serum IgE in asthmatic children sensitized to Dermatophagoides pteronyssinus. Arch Med Res 2007 Jan;38(1):99-105. DOI: 10.1016/j.arcmed.2006.07.007

Toelle BG, Peat JK, Salome CM, Mellis CM, Woolcock AJ. Toward a definition of asthma for epidemiology. Am Rev Respir Dis 1992 Sep;146(3):633-7. DOI: 10.1164/ajrccm/146.3.633

Peat JK, Toelle BG, Salome CM, Woolcock AJ. Predictive nature of bronchial responsiveness and respiratory symptoms in a one year cohort study of Sydney schoolchildren. Eur Respir J 1993 May;6(5):662-9.

Naqvi N, Choudhry S, Tsai HJ, Thyne S, Navarro D, Nazario S, et al. Association between IgE levels and asthma severity among African American, Mexican, and Puerto Rican patients with asthma. J Allergy Clin Immunol 2007 Jul;120(1):137-43. DOI: 10.1016/j.jaci.2007.02.045

Rosario CS, Rosario NA, Neto HJC, Reidi CA, Lima M. Total Serum IgE Levels in Asthmatic Children. J Allergy Clin Immunol 2016;137(2):AB203. DOI: 10.1016/j.jaci.2015.12.1104.

Begum JA, Islam MI, Hoque SK, Islam MT, Hossain MZ, Matin A. Relationship between IgE levels and lung function tests in children with Asthma. J Dhaka Med Coll 2010; 19(1): 3-6.

Satwani H, Rehman A, Ashraf S, Hassan A. Is serum total IgE levels a good predictor of allergies in children? J Pak Med Assoc 2009 Oct;59(10):698-702.

Afzal M, Qureshi SM, Hussain S, Tariq NA, Khan MB. Risk factors associated with childhood asthma among children aged 1-12 years in Rawalpindi. Pak Armed Forces Med J (PAFMJ) 2011 Sep;61(3).

Lama M, Chatterjee M, Chaudhuri M. Total serum immunoglobulin E in children with asthma. Indian J Clin Biochem 2013;28(2):197-200. DOI 10.1007/s12291-012-0247-2.

Iqbal J, Azhar MA, Gardezi A. IgE mediated asthma- effect of gender on management. Ann Pak Inst Med Sci 2014;10(4):198-202

Haselkorn T, Szefler SJ, Simons FER, Zeiger RS, Mink DR, Chipps BE, et al. Allergy, total serum immunoglobulin E, and airflow in children and adolescents in TENOR. Pediatr Allergy Immunol 2010 Dec:21(8):1157–65. DOI: 10.1111/j.1399-3038.2010.01065.x.

Borish L, Chipps B, Deniz Y, Gujrathi S, Zheng B, Dolan CM, et al. Total serum IgE levels in a large cohort of patients with severe or difficult-to-treat asthma. Ann Allergy Asthma Immunol 2005 Sep;95(3):247-53. DOI: 10.1016/S1081-1206(10)61221-5