{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:21:19Z","timestamp":1789165279629,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:00:00Z","timestamp":1751068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The paucity of real\u2010world data on the aetiology of elevated total serum immunoglobulin E (TS\u2010IgE) in children afflicts families and health care systems with diagnostic uncertainty. We explored a cohort of children with TS\u2010IgE levels over 1000 kU\/L, focusing on the prevalence of atopic and non\u2010atopic conditions, the aetiology of extremely elevated TS\u2010IgE and the relevance of TS\u2010IgE levels for the diagnosis of non\u2010atopic diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from paediatric patients managed at HUS Group hospitals in Finland between 1998 and 2024 were queried for TS\u2010IgE levels and International Classification of Diseases (ICD)\u201010 diagnostic codes. A chart review was performed for patients with non\u2010atopic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our cohort included 2431 children with TS\u2010IgE levels over 1000\u2009kU\/L; for 2061 of them, ICD\u201010 codes were available. Non\u2010atopic conditions rarely caused TS\u2010IgE elevation (45\/2061 patients, 2%), even in children with extremely high (&gt;\u200915\u2009000 kU\/L,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200976) TS\u2010IgE levels. Graft\u2010versus\u2010host disease and inborn errors of immunity were the most common non\u2010atopic aetiologies of TS\u2010IgE elevation. All children with non\u2010atopic conditions manifested distinct clinical symptoms, and TS\u2010IgE level was irrelevant for reaching the diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Non\u2010atopic conditions were uncommon and clinically obvious in children with elevated TS\u2010IgE; therefore, we question the diagnostic relevance of TS\u2010IgE measurement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70205","type":"journal-article","created":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T09:28:55Z","timestamp":1751102935000},"page":"2993-2999","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Aetiology of Elevated Total Serum Immunoglobulin E in Children"],"prefix":"10.1111","volume":"114","author":[{"given":"Aliisa","family":"\u00c4r\u00f6l\u00e4","sequence":"first","affiliation":[{"name":"New Children's Hospital and Pediatric Research Center University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3379-1139","authenticated-orcid":false,"given":"Kaarina","family":"Kukkonen","sequence":"additional","affiliation":[{"name":"New Children's Hospital and Pediatric Research Center University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4573-3297","authenticated-orcid":false,"given":"Svetlana","family":"Vakkilainen","sequence":"additional","affiliation":[{"name":"New Children's Hospital and Pediatric Research Center University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.11.017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.04.009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13073"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacig.2025.100403"},{"key":"e_1_2_10_6_1","unstructured":"G.Rebecca \u201cDifferences Between Children and Adult Patients With Extremely High IgE Levels: One Center Experience\u201d(2024) Programs and Abstracts of Papers to be Presented During Scientific Sessions: 2024 AAAAI Annual Meeting; Feb 2024."},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","unstructured":"R. M.Elias \u201cSubjects With Extremely Elevated IgE Levels: A Descriptive Study\u201d(2011) Program and Abstracts of Papers to be Presented During the 2011 Annual Meeting.","DOI":"10.1016\/j.jaci.2010.12.842"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2009.09.008"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12623"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18378"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2007.03407.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62178-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60170-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.08.008"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T09:38:35Z","timestamp":1763804315000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,28]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/apa.70205"],"URL":"https:\/\/doi.org\/10.1111\/apa.70205","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,28]]},"assertion":[{"value":"2025-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}