Total Immunoglobin E: Clinical Utility and Measurement

Total Immunoglobulin E (tIgE) is still being ordered alone or along with allergen specific IgE as first line test to diagnose allergic diseases in primary care settings. It has been well established that elevated serum tIgE levels are of very limited clinical utility in allergy as it does not give any information of sensitizing allergens in an individual. TIgE levels are shown to be useful to screen for presumptive diagnosis of IgE myeloma (myeloma that selectively produce IgE par protein). Though tIgE immunoassay are one of the most well standardized assays with high precision and reproducibility, its main utility appears to be limited to evaluate and monitor patients as candidates for the receiving anti-IgE therapy. TIgE is a nonspecific allergy marker and is replaced by more specific and sensitive markers as specific-IgE (sIgE) and component-resolved diagnostics.