What to Know About High Immunoglobulin (IgE) Levels

Symptoms, Causes, and Whether Certain Levels Are Dangerous

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IgE is an antibody that plays a key role in allergic responses. It can sometimes also be elevated for other reasons, such as chronic infections or inflammatory diseases. When your IgE levels are high, additional testing is often needed depending on your symptoms.

High IgE levels aren’t necessarily dangerous, but they do give your healthcare provider important information about your chance of having allergies, an infection, an autoimmune disease, or certain other conditions.

This article discusses IgE and what high levels of this antibody could mean. It also discusses how high IgE is diagnosed and treated.

Doctor giving patient blood test for IgE levels
Philippe Roy / Getty Images

What Is IgE?

IgE is naturally produced by B cell lymphocytes, a type of immune white blood cell. This antibody normally activates physical responses to help your body fight infections.

What Are the Five Immunoglobulins and What Do They Do?

  • IgA is found in mucosal tissue, such as the respiratory tract and digestive system, and defends against infections.
  • IgD binds to B cells to initiate an immune response but its role is not well understood. It is found in small amounts in the blood.
  • IgG is the most common type of antibody. It is found in blood and bodily fluids and defends against viruses and bacteria.
  • IgE is part of allergic reactions and defends against parasites. It is found in small amounts in the blood.
  • IgM is the first to fight infections and help trigger the release of other antibodies. It is found in blood and lymph fluid.

For some people, exposure to allergens—which are harmless, non-infectious substances (like dust or pollen)—can also trigger the body to produce and release IgE.

In these situations, IgE antibodies bind to the allergen and trigger an inflammatory response that can manifest with allergy symptoms such as a skin rash, sneezing, and swollen lips. When it results in asthma, it is considered the allergic type.

Common allergens include:

When your body releases IgE, a cascade of immune responses follows, some of which are mediated by other immune cells in the body. IgE is believed to bind to and activate immune cells, such as basophils and mast cells. When IgE binds with any of these cells, it can overstimulate your immune system. Additionally, your capillaries widen and become leakier, increasing inflammation by allowing the immune cells to cluster around the allergen.

Normal IgE Levels

A normal IgE range is typically between 0 IU/mL and 100 IU/mL for adults. For children, normal ranges vary based on age.

Symptoms of High IgE

Symptoms that may occur along with high IgE levels depend on the condition. For example, if you have allergies you may have itchy eyes, sneezing, coughing, and congestion. 

If your high IgE levels are related to a skin condition, you may experience symptoms like red, itchy, flaking skin or recurring skin infections.

If you have allergic asthma, your bronchi (airways) can become narrow and inflamed due to the rush of immune cells, which rapidly exacerbates asthma symptoms like wheezing, coughing, and shortness of breath. Your airways may also suddenly spasm, making it difficult for air to pass as you try to breathe.

The symptoms are usually mild, but in some cases, they can become severe and may cause serious consequences, such as a life-threatening respiratory crisis.

High IgE may also cause fatigue.

Causes of High IgE

Causes of high IgE can range from allergies to infections. Less commonly, a condition such as a blood cancer may cause elevated IgE levels.

Allergic Conditions

There are many types of allergic responses that may lead to high IgE levels. These include:

An elevated IgE level supports the diagnosis of allergic asthma but does not give an indication of what the trigger(s) of your attacks could be.

Infections

Parasitic infections are the most common type of infection associated with high IgE levels, but high levels can also occur along with certain viral, bacterial, or fungal infections.

Infections associated with high IgE include:

Autoimmune and Inflammatory Diseases

Autoimmune diseases occur when the immune system mistakenly attacks its own tissues. Inflammatory diseases occur when there is an excess immune response that leads to inflammation. These can also be associated with high IgE.

Examples include:

  • Rheumatoid arthritis, an autoimmune disease that often affects joints
  • Lupus, an autoimmune disease that can affect tissues and organs
  • Celiac disease, an autoimmune disease that leads to damage of the small intestine from an immune response to gluten
  • Churg-Strauss syndrome, a rare autoimmune disorder that causes vasculitis (an inflammation of blood vessels)
  • Kawasaki disease, a rare inflammatory condition in children under age 5 that may be due to an infection and can affect the heart
  • Kimura disease, an inflammatory condition that causes swelling under the skin of the head and neck
  • Hyper IgE syndrome, a rare immunodeficiency disease that causes recurrent skin infections and other skin problems like eczema. People with this condition may also experience recurrent lung infections.

Other immunodeficiencies, or conditions that impair the immune system’s ability to fend off infections, may also contribute to high IgE.

Blood-Related Cancers

High IgE is also associated with certain blood-related cancers. This includes Hodgkin lymphoma, a type of blood cancer that starts in the lymph nodes, and IgE myeloma, a rare type of cancer that affects a type of white blood cells in bone marrow.

Other Conditions

There are some other conditions and behaviors associated with high IgE:

Complications

High IgE levels can lead to varying complications, depending on the condition causing them. Hyper IgE syndrome, for example, may cause complications such as frequent skin infections, chronic lung disease, and pulmonary insufficiency. People with hyper IgE syndrome also have an elevated risk of developing lymphoma.

High IgE levels may also be a risk factor for atherosclerosis, a condition where plaque builds up in the arteries, causing hardening.

Diagnosis

Your healthcare provider will assess your symptoms and order additional tests to find the cause. Symptoms that suggest an allergic cause include itchy eyes, nausea, sneezing, coughing, and congestion.

Sometimes the pattern of symptoms can point to allergic asthma when symptoms tend to occur in relation to allergen exposure. Allergy testing can help identify what may be triggering your condition.

IgE Testing

IgE testing may be done if your healthcare provider suspects a condition such as allergic asthma. Your healthcare provider will consider your results in the context of your symptoms and other diagnostic measures.

Treatment

If you have high IgE levels, your treatment will vary depending on the condition that’s causing them.

For example, there are a number of treatments for allergic asthma, including avoiding allergens that are asthma triggers, if possible. However, it is not always possible to avoid allergens, especially if they are highly prevalent in the environment. In that case, other treatments may be used:

  • Inhalers containing immunosuppressants or bronchodilators are commonly used to treat allergic asthma. 
  • Anti-IgE medication such as Xolair (omalizumab) can be used along with bronchodilators. Your IgE level can help your healthcare provider determine whether you might benefit from treatment that can lower IgE. But a high level is not a requirement for treatment with an anti-IgE.

Other types of allergic reactions may be treated with decongestants and antihistamines. Severe allergic reactions may need to be treated with epinephrine.

Other conditions have varying treatments. For example, autoimmune conditions like lupus may be treated with immunosuppressant drugs, while lymphoma may be treated with chemotherapy or radiation.

Summary

High IgE levels can be associated with a number of conditions, such as allergies, allergic asthma, infections, and autoimmune conditions. 

Treatment for high IgE levels involves treating the underlying cause. If your symptoms are caused by allergic asthma, for example, you may benefit from anti-IgE medication. Other conditions have varying treatments.

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Pat Bass, MD

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.