Concentrations of
IgD and
IgE were measured in sera from 165 patients with well-defined immunodeficiency in an effort to find information possibly relevant to the roles of
antibodies of these classes in host defense. Values for both
immunoglobulins were generally quite low in patients who had marked deficiencies of all three major
immunoglobulins, although occasional normal or high normal values for
IgD were seen in hypogammaglobulinemic patients. Group mean
IgD concentrations were also depressed in patients with
Wiskott-Aldrich syndrome and in those with selective
IgA deficiency;
IgE concentrations were depressed in patients with X-linked immunodeficiency with hyper-
IgM and in those with
ataxia telangiectasia.
IgD and
IgE were both significantly elevated in patients with extreme
hyperimmunoglobulinemia E and undue susceptibility to
infection and in a patient with the
Nezelof syndrome; none of these patients had histories suggestive of atopy. In addition, the mean
IgE concentration was significantly elevated in patients with selective
IgA deficiency, many of whom were atopic, and in those with the
Wiskott-Aldrich syndrome. The highest
IgD concentration (163 mg/100 ml) was found in serum from a boy with variable immunodeficiency who had a lifelong history of severe recurrent pharyngeal
infections, primarily streptococcal in etiology. Recurrent
staphylococcal infection was a feature common to many but not all patients with elevated serum
IgE concentration. These data may prove useful in the future delineation of
biologic roles for
antibodies in these two
immunoglobulin classes.