Allergens, Immunoglobulin E, Asthma exacerbation, Childhood Asthma


Background: The involvement of IgE in type 1 hypersensitivity reactions, including asthma and allergic rhinitis, is widely recognized, and established. However, within this region, there exists a dearth of research exploring the relationship between serum IgE levels and the severity of asthma within the pediatric population. Consequently, the primary objective of this study was to compare the IgE status among children and adolescents diagnosed with asthma, and to examine its association with asthma exacerbations and hospitalizations. By investigating these parameters, we aimed to shed light on the potential role of IgE in influencing disease outcomes in this specific population. Methods: A retrospective study was conducted at The Aga Khan University Hospital from January 2015 to December 2020. Children and adolescents aged 6–18 years who were diagnosed and admitted with asthma, and who had measurement of IgE levels during asthma exacerbation were included in the study. The participants were stratified into two groups based on their IgE levels: normal IgE levels and high IgE levels. Various parameters, including the number of asthma exacerbations, emergency room (ER) visits, hospitalizations, average length of stay, as well as other clinical characteristics such as the presence of allergic rhinitis in the past and a family history of asthma were assessed. Results: A total of 122 patients were included in the study. Of them 57 patients (46.72%) were found to have high IgE levels, and 65 patients (53.28%) had normal IgE levels based on their age group. The average number of exacerbations per year was significantly greater the in high IgE group (3.6±1.09), in comparison to the normal IgE group (2.49±1.22). Conclusion: Higher serum IgE levels correlated with increased asthma exacerbations, emergency room visits, hospitalizations, and a positive family history of asthma, suggesting a potential link between IgE and asthma severity in the pediatric population of Pakistan.

Author Biographies

Danish Abdul Aziz, Department of Paediatrics and Child Health, Aga Khan University Hospital Karachi-Pakistan


Rameen Ata Bajwa, Department of Paediatrics and Child Health, Aga Khan University Hospital Karachi-Pakistan


Muhammad Omar, Department of Paediatrics and Child Health, Aga Khan University Hospital Karachi-Pakistan


Werdah Viquar , Department of Paediatrics and Child Health, Aga Khan University Hospital Karachi-Pakistan



Dharmage SC, Perret JL, Custovic A. Epidemiology of Asthma in Children and Adults. Front Pediatr 2019;7:246.

Asthma NAE and PP Third Expert Panel on the Diagnosis and Management of. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute (US); 2007.

Naqvi M, Choudhry S, Tsai HJ, Thyne S, Navarro D, Nazario S, et al. Association between IgE levels and asthma severity among African American, Mexican, and Puerto Rican patients with asthma. J Allergy Clin Immunol 2007;120(1):137–43.

Samitas K, Delimpoura V, Zervas E, Gaga M. Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives. Eur Respir Rev 2015;24(138):594–601.

Serebrisky D, Wiznia A. Pediatric Asthma: A Global Epidemic. Ann Glob Health 2019;85(1):6.

Sunyer J, Antó JM, Sabrià J, Roca J, Morell F, Rodríguez-Roisin R, et al. Relationship between serum IgE and airway responsiveness in adults with asthma. J Allergy Clin Immunol 1995;95(3):699–706.

Borish L, Chipps B, Deniz Y, Gujrathi S, Zheng B, Dolan CM. Total serum IgE levels in a large cohort of patients with severe or difficult-to-treat asthma. Ann Allergy Asthma Immunol 2005;95(3):247–53.

Siroux V, Oryszczyn MP, Paty E, Kauffmann F, Pison C, Vervloet D, et al. Relationships of allergic sensitization, total immunoglobulin E and blood eosinophils to asthma severity in children of the EGEA Study. Clin Exp Allergy 2003;33(6):746–51.

Unal D, Gelincik A, Elitok A, Demir S, Olgac M, Coskun R, et al. Impact of high serum Immunoglobulin E levels on the risk of atherosclerosis in humans. Asia Pac Allergy 2017;7(2):74–81.

Havnen J, Amlie PA, Hvatum M, Oseid S, Veggan T, Aas K. IgE concentrations in allergic asthma in children. Arch Dis Child 1973;48(11):850–5.

Ng C, Hon KL, Kung JS, Pong NH, Leung TF, Wong CK. Hyper IgE in Childhood Eczema and Risk of Asthma in Chinese Children. Molecules 2016;21(6):753.

Lama M, Chatterjee M, Chaudhuri TK. Total serum immunoglobulin e in children with asthma. Indian J Clin Biochem 2013;28(2):197–200.

Satwani H, Rehman A, Ashraf S, Hassan A. Is serum total IgE levels a good predictor of allergies in children? J Pak Med Assoc 2009;59(10):698–702.

D'Amato G, Liccardi G, Noschese P, Salzillo A, D'Amato M, Cazzola M. Anti-IgE monoclonal antibody (omalizumab) in the treatment of atopic asthma and allergic respiratory diseases. Curr Drug Targets Inflamm Allergy 2004;3(3):227–9.

Milgrom H, Berger W, Nayak A, Gupta N, Pollard S, McAlary M, et al. Treatment of childhood asthma with anti-immunoglobulin E antibody (omalizumab). Pediatrics 2001;108(2):E36.

Mrazek DA, Klinnert M, Mrazek PJ, Brower A, McCormick D, Rubin B, et al. Prediction of early-onset asthma in genetically at-risk children. Pediatr Pulmonol 1999;27(2):85–94.

Foong RX, du Toit G, Fox AT. Asthma, Food Allergy, and How They Relate to Each Other. Front Pediatr 2017;5:89.

Chabra R, Gupta M. Allergic and Environmentally Induced Asthma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Aug 16]. Available from:

Forno E, Celedón JC. Predicting asthma exacerbations in children. Curr Opin Pulm Med 2012;18(1):63–9.

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention [Internet]. 2022. [cited 2023 Aug]. Available from:

Khan SW, Hamid A, Siddiqi FA, Bakhtawar M. Frequency of allergic asthma and common aeroallergens sensitization in Pakistani patients of bronchial asthma. J Pak Med Assoc 2018;68(8):1217–21.

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