Children with allergic conditions had upper percentile immunoglobulin E levels more than 30 times higher than those without allergies, according to a recent study.
A prospective cross-sectional study, published in Pathology, was conducted to establish continuous age-related reference intervals (RIs) for total serum immunoglobulin E (IgE) in healthy term neonates and children, with and without allergic conditions. IgE is an antibody involved in allergic sensitization and immune defense against helminths, with concentrations that vary by age and are typically higher in patients with allergic disease. Previous studies have provided partitioned RIs, which may not reflect gradual age-related changes.
This investigation, part of the Harmonising Age Pathology Parameters in Kids project, included 441 participants from Melbourne, Australia, recruited between 2015 and 2016. Twelve neonates (≤72 hours old) and 429 children aged 30 days to 18 years were included, with 51.5 percent male representation. Of these, 305 participants had no reported allergic conditions, and 136 reported at least one allergic diagnosis (asthma, eczema, hay fever, or food allergy). Venous blood samples were collected during minor surgical procedures or routine neonatal care, processed under standardized laboratory protocols, and analyzed using a fluoroenzyme immunoassay.
Fractional polynomial regression and quantile regression were used to generate continuous RIs for the 2.5th and 97.5th percentiles, stratified by allergy status. In the non-allergic cohort, the 2.5th percentile RI was 2.00 IU/mL, and the 97.5th percentile was calculated as 37.29 + 101.95 × (age/10). In the allergic cohort, the corresponding equations were 1.50 + 0.30 × (age/10) for the lower bound and 1751.73 + 14.82 × (age/10) for the upper bound. IgE concentrations increased with age in both cohorts. The upper percentile values in the allergic group were more than 30 times higher than those in the non-allergic group, with smaller age-related variation observed in the allergic group.
This study reported continuous, equation-based pediatric IgE RIs using the fluoroenzyme immunoassay method in an ethnically diverse Australasian cohort. Separate RIs for allergic and non-allergic groups were provided. The non-allergic RIs may be applicable to other laboratories using the same analytical platform, but local verification is recommended due to possible demographic and environmental differences. The methodology described can be adapted by laboratories to establish population-specific continuous RIs.
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