Sajna Gamaly Leela1, Menon Narayanankutty Sunilkumar2, Ramaraj Subbiah3
BACKGROUND
Bronchial asthma is a major public health concern especially in the paediatric
population. An elevated immunoglobulin E (IgE) level is considered as an objective
marker of allergy. Because IgE is a mediator of allergic response, quantitative
measurement of IgE together with other clinical markers, can provide useful
information for the differentiation between atopic and non-atopic diseases. In this
study, we wanted to determine serum IgE and absolute eosinophil count (AEC)
levels and correlate both levels with severity of asthma in children in the age group
of 2 - 15 years admitted in the paediatric department.
METHODS
This is a descriptive cross-sectional study. After taking the informed consent from
the parent or guardian, relevant information on asthmatic symptoms and severity,
other associated manifestations, precipitating factors, and family history of asthma
were recorded in a pre-designed proforma. A total of 65 children (age group 2 –
15 years old) with bronchial asthma were studied. Investigations such as
hemogram and serum IgE levels were determined. Asthma severity was assessed
according to global initiative for asthma (GINA) guidelines.
RESULTS
Among 65 children, 69.2 % were boys. Receiver operating characteristic curve
(ROC) analysis showed that total IgE cut-off concentration of 168 IU/ml,
distinguishes children with intermittent asthma from those with mild persistent
disease. IgE cut-off concentration of 989 IU/ml distinguishes mild persistent from
those with moderate persistent asthma. Both showed adequate or good diagnostic
efficacy. Cut off value of 168 IU/ml may prove useful in practice, indicating that
75 % of children in intermittent group will have serum concentration of total IgE
< 168 IU/ml. No association was observed between AEC and increasing severity
of asthma. Only atopic dermatitis with asthma showed increasing trend of IgE
levels.
CONCLUSIONS
Asthmatic children with higher asthma severity have a higher serum total IgE
concentration (168 IU/ml and 989 IU/ml are the cut off values for differentiating
intermittent from mild persistent and mild persistent from moderate persistent).
