xRead - September 2022

Wise et al.

Page 336

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE VIII.F.1-1. Evidence supporting the use of total IgE in allergic rhinitis or allergy diagnosis Study Year LOE Study design Study groups Endpoint Conclusion a Park et al. 902 2016 2b Prospective cohort 313 school children, 2-year follow-up study Initial examination: no allergic sensitization, serum tIgE >17.7 IU/mL Associated with the risk for allergic sensitization (sensitivity: 46.3%; specificity: 85.3%; OR: 4.8). Initial examination: allergic symptoms but negative SPT, serum tIgE >17.4 IU/mL Associated with newly developed allergic sensitization (sensitivity: 69.9%; specificity: 100.0%). Demirjian et al. 896 2012 2b Prospective cohort Patients referred to allergy clinic. Total patients (n = 358,184 with rhinitis), mean age 57 years. Serum tIgE (IU/mL), continuous variable tIgE levels >140 IU/mL is suggestive of an atopic etiology for patients with rhinitis. Jung et al. 895 2011 2b Prospective cohort Patients with AR symptoms (n = 442), median age 33 years. 6.93; 95% CI, 4.19–9.62; p < 0.001); AUC: 0.79 [range, 0.74– 0.83]; PPV: 71.3%; NPV: 73.7%. Marinho et al. 893 2007 2b Whole population birth cohort 478 children from MAAS Serum tIgE (kU/L), continuous variable Borderline association with current rhinitis (UnAdjOR b 1.2; Li et al. 901 2016 3b Retrospective case series Serum tIgE (IU/mL), continuous variable Chung et al. 899 2014 3b Retrospective case series Serum tIgE level >150 IU/mL 95% CI, 1.02–1.3), not significant at multivariate analysis. Association with current rhinoconjunctivitis (UnAdjOR b 1.3; 95% CI, 1.1–1.5), not significant at multivariate analysis. Patients from otolaryngology clinic. Total patients (n = 610 adults, 349 with AR), median age 27.0 years. Serum tIgE were higher in AR (166.0 [range, 58.4–422.5] IU/mL) than in NAR pts (68.8 [range, 24.5–141.0]) IU/mL. p < 0.001 Patients from otolaryngology clinic. Total patients (n = 1073 children and adults, 753 with rhinitis), mean age 36.9 years. Jacobs et al. 900 2014 3b Cross-sectional 547 children (6–14 years) from randomly selected households; 265 with skin test positive AR. case series, followed by a

Elevated serum tIgE in the presence of a negative inhalant specific IgE screen may suggest the presence of unidentified inhalant allergen sensitization or chronic respiratory inflammatory disease other than AR. Mean serum tIgE of the study group was 363.3 kU/L vs control group 2.2 kU/L, p < 0.0001.

Serum tIgE levels (cutoff value: 150 IU/mL) has good PPV (89.6%), and NPV (10%) in the in vitro diagnosis of AR (AUC: 0.88).

Log serum tIgE (kU/L) Serum tIgE level are significantly associated with increased odds of skin test positive AR in children with asthma (OR 2.3; 95% CI, 1.5–3.5) but not with those without asthma (OR 1.6;

95% CI, 0.9–2.8). AR can be diagnosed if serum tIgE ≥100 kU/L both in asthmatics (AUC: 0.77 [range, 0.72–0.82], PPV: 85.1%, NPV: 68%) and in non-asthmatics (AUC: 0.84 [range, 0.79–0.89], PPV: 77.8%, NPV: 90.9%).

Serum tIgE >98.7 IU/mL tIgE cutoff: 98.7 IU/mL is a strong predictor of AR. (OR Serum tIgE (kU/mL), continuous variable

group and 19.2% of control group; p < 0.0001.

1 30 patients (≥6 years) with a negative allergy screen and serum tIgE >116 kU/L;

2 26 control patients with negative allergy screen and stIgE < 2.95 kU/L; Chronic sinusitis in 76.9% of study

prospective study

Hatcher et al. 897 2013 3b Retrospective

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.