What to do about high IgE?

[TinToronto]

I have had my IgE tested twice now and each time the results were over 7000. For this reason I have been denied Xolair. My asthma, eczema and allergies are brutal.

Other than Xolair what options are there for someone like me? There must be others out there?

[TinToronto]

Hello Dr.

It has been quite a while since my last post. I did finally get approved fro Xolair. Unfortunately, the treatment was extremely expensive (over $6000 per year with 90% drug coverage) and for some reason my skin thickened more than usual. It was very successful with my asthma however.

I am now on Spiriva, Methotrexate, Lyderm cream for body and Hydroval for face. This has helped my eczema and asthma tremendously.

I have only one other complaint now, that is reoccurring infections such as otitis media, staph infections, cellulitus, etc. These infections are occurring monthly now. I am wondering if this is due to the lowering of my immune system from the methotrexate and high use of corticosteroids.

I am also not clear, how to determine if I have Hyper IgE syndrome (Job's Syndrome). My concern with this are long term effects of infections and scarring. I am now 45 years old, so these things have become more important to me.

Any advise from anyone, is most appreciated!

Cheers,
TinToronto.

[Bhupinder Kaur, MD]

Hello,
Xolair is clearly known to improve symptoms in asthma and atopic dermatitis but there are a number of case reports suggesting improvement with both asthma and ABPA in patients with IgE level with Omalizumab. Hence you can discuss the treatment options with your immunologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.