PMID- 38084204
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 2000-1967 (Electronic)
IS  - 0300-9734 (Print)
IS  - 0300-9734 (Linking)
VI  - 128
DP  - 2023
TI  - Reference values of serum total IgE in Uppsala - comparison over four decades.
LID - 10.48101/ujms.v128.9892 [doi]
AB  - BACKGROUND: Total immunoglobulin E (IgE) analysis is a common tool in allergy 
      diagnosis. Suggested reference values for IgE are divergent and sometimes based 
      on outdated assay methods. We aimed to validate the published reference values 
      (geometric mean [GM]: 13.2 kU/L, upper limit of normal [ULN], 114 kU/L) shown in 
      an Uppsala cohort from 1974 using Phadebas IgE PRIST, and the suggested clinical 
      threshold of 100 kU/L (Zetterstrom and Johansson 1981). METHODS: Immunoglobulin E 
      was measured in two Uppsala cohorts from 1997 (Blood bank) and 2011 to 2013 (the 
      European community respiratory health survey part III [ECRHS III]) using 
      ImmunoCAP Total IgE. For the reference value calculations, exclusion criteria 
      were atopy (both cohorts), doctor's diagnosis of asthma and self-reported allergy 
      (hay fever, rhinitis, rash) (only ECRHS III). Upper limit of normal was defined 
      as mean + 2 standard deviations (SD) calculated using log-transformed values and 
      back-transformation of the ULN prior to presentation. Common imputation methods 
      for results below the assay range were evaluated. RESULTS: The average GM was 
      14.2 kU/L (Blood bank, n = 63; imputation method range: 16.9-17.4 kU/L; ECRHS 
      III, n = 113: 10.7-11.6 kU/L) and the overall mean ULN was 118 kU/L (Blood bank: 
      113-130 kU/L; ECRHS III: 104-128 kU/L). The clinical sensitivity and specificity 
      of the 100 kU/L IgE threshold were 37.8 and 94.3% for atopy, 34.9 and 89.5% for 
      doctor's diagnosis of asthma, and 24.5 and 97.3% for any self-reported allergy 
      (ECRHS III). CONCLUSION: The calculated ULN values were similar between the 
      cohorts. We conclude that the total IgE reference values shown for Uppsala 
      subjects from 1974 are still valid and suitable also for the ImmunoCAP Total IgE 
      assay. The 100 kU/L threshold for total IgE had a low sensitivity but high 
      specificity for atopy, asthma, and allergy.
CI  - (c) 2023 The Author(s). Published by Upsala Medical Society.
FAU - Moverare, Robert
AU  - Moverare R
AUID- ORCID: 0000-0001-6611-5036
AD  - Thermo Fisher Scientific, Uppsala, Sweden.
AD  - Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala 
      University, Uppsala, Sweden.
FAU - Persson, Eilif
AU  - Persson E
AUID- ORCID: 0009-0007-3128-1481
AD  - Thermo Fisher Scientific, Uppsala, Sweden.
FAU - Malinovschi, Andrei
AU  - Malinovschi A
AUID- ORCID: 0000-0002-4098-7765
AD  - Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, 
      Sweden.
FAU - Janson, Christer
AU  - Janson C
AUID- ORCID: 0000-0001-5093-6980
AD  - Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala 
      University, Uppsala, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20231208
PL  - Sweden
TA  - Ups J Med Sci
JT  - Upsala journal of medical sciences
JID - 0332203
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Humans
MH  - Reference Values
MH  - Immunoglobulin E
MH  - *Hypersensitivity/diagnosis
MH  - *Asthma/diagnosis
MH  - Sensitivity and Specificity
PMC - PMC10710850
OTO - NOTNLM
OT  - Allergy
OT  - asthma
OT  - atopy
OT  - reference value
OT  - total IgE
OT  - upper limit of normal
COIS- Robert Moverare is employed by Thermo Fisher Scientific (and minor shareholder). 
      Eilif Persson is retired from the company. The other authors declare no conflict 
      of interest.
EDAT- 2023/12/12 06:42
MHDA- 2023/12/17 09:46
PMCR- 2023/12/08
CRDT- 2023/12/12 03:37
PHST- 2023/08/18 00:00 [received]
PHST- 2023/11/10 00:00 [revised]
PHST- 2023/11/13 00:00 [accepted]
PHST- 2023/12/17 09:46 [medline]
PHST- 2023/12/12 06:42 [pubmed]
PHST- 2023/12/12 03:37 [entrez]
PHST- 2023/12/08 00:00 [pmc-release]
AID - 9892 [pii]
AID - 10.48101/ujms.v128.9892 [doi]
PST - epublish
SO  - Ups J Med Sci. 2023 Dec 8;128. doi: 10.48101/ujms.v128.9892. eCollection 2023.