IgE in Infants with Laryngomalacia: Risk for Asthma

Abstract

Objective: To evaluate a possible predictive value for developing asthma later on in infants with laryngomalacia by measuring specific immunoglobulin E (IgE) antibodies to food and/or inhalant allergens. Method: Sixty-four children having congenital laryngeal stridor “laryngomalacia” before 18 months of age were followed prospectively until early school age. Serum levels of food and inhalant allergen-specific IgE antibodies were determined at presentation, using the CAP system IgE FEIA (Pharmacia, Uppsala, Sweden). At 6 to 8 years, the children were evaluated for asthma and allergic manifestations. Results: Asthma was present in 24 (37.5%) children at school age. Food-specific IgE antibodies of ≥ 0.35 kU/L were found in 27 (42%) infants, but only specific IgE to wheat and to egg white at the level of ≥ 0.35 kU/L were significantly associated with later asthma. In regard to specific IgE to the mixture of food allergens, the cutoff level of ≥ 0.70 proved to be significant. Inhalant allergen-specific IgE of ≥ 0.35 kU/L was found in 16 cases (25%) and was significantly predictive of asthma. Conclusion: Presence of specific IgE of ≥ 0.35 kU/L to wheat, egg white, or inhalant allergens are predictive of later childhood asthma. Consequently, detection of those specific IgE antibodies in those infants may facilitate the early diagnosis of asthma, especially in cases with no clinically evident atopic manifestations.