Differential Diagnosis of Raised IgE

The following is a differential diagnosis for raised IgE levels, categorized for clarity and emphasis on critical conditions.

• Single Most Likely Diagnosis

  • Atopic Diseases: Such as asthma, atopic dermatitis, and allergic rhinitis. These conditions are commonly associated with elevated IgE levels due to an allergic response.

• Other Likely Diagnoses

  • Parasitic Infections: Many parasitic infections, including hookworm, roundworm, and tapeworm infections, can cause an increase in IgE levels as part of the body's immune response.
  • Allergic Bronchopulmonary Aspergillosis (ABPA): A condition that occurs in people with asthma or cystic fibrosis, characterized by an allergic reaction to Aspergillus fungi, leading to elevated IgE levels.
  • Hyper-IgE Syndrome (Job Syndrome): A rare primary immunodeficiency characterized by recurrent cutaneous and pulmonary infections and elevated IgE levels, but it's more likely than some of the conditions listed under rare.

• Do Not Miss Diagnoses

  • Lymphoma: Certain types of lymphoma can cause elevated IgE levels. Although less common, missing a diagnosis of lymphoma could have severe consequences.
  • Hypereosinophilic Syndrome: A condition characterized by an overproduction of eosinophils, which can be associated with elevated IgE levels and has significant implications for patient management.

• Rare Diagnoses

  • Wiskott-Aldrich Syndrome: A rare genetic disorder that affects the immune system and is characterized by eczema, thrombocytopenia, and recurrent infections, with elevated IgE levels.
  • Omenn Syndrome: A rare form of severe combined immunodeficiency (SCID) that presents with elevated IgE levels, eosinophilia, and lymphadenopathy.
  • Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis): A rare autoimmune condition that can cause elevated IgE levels, characterized by asthma, eosinophilia, and vasculitis.