(See also Overview of Immunodeficiency Disorders.)
Hyper-IgE syndrome is a primary immunodeficiency disorder. It may be inherited in one of two ways:
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As an autosomal (not sex-linked) dominant disorder: That is, only one gene for the disorder, one from either parent, is required.
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As an autosomal recessive disorder: That is, two genes for the disorder, one from each parent, are required.
How hyper-IgE is inherited depends on which gene is affected. Why levels of IgE are high is unknown. Both forms cause similar symptoms.
Symptoms
Symptoms of hyper-IgE syndrome usually begin during infancy. In most infants, pockets of pus (abscesses) form in the skin, joints, lungs, or other organs. The abscesses are usually caused by infections with staphylococcal bacteria, and they recur frequently.
People may develop respiratory infections, including pneumonia that may leave giant cysts after the pneumonia has resolved.
An itchy rash develops.
Bones are weak, resulting in many fractures. Facial features may be coarse. Loss of baby teeth is delayed.
Life span depends on the severity of the lung infections.
Diagnosis
Treatment
Antibiotics, usually trimethoprim/sulfamethoxazole, are given continuously to prevent staphylococcal infections.
The rash is treated with moisturizing creams, antihistamines, and, if infection is likely, antibiotics. Respiratory infections are treated with antibiotics.
Certain drugs that modify the immune system, such as interferon gamma, are sometimes helpful.
