{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:05:28Z","timestamp":1789563928892,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To clarify the aetiology and clinical relevance of markedly elevated total serum immunoglobulin E (IgE) levels (\u2265\u20091000\u2009IU\/mL) in children and to characterise the longitudinal outcomes of patients with persistently elevated IgE levels in whom no underlying cause can be identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included children aged 1\u201318\u2009years evaluated between September 2019 and June 2025 with total serum IgE levels\u2009\u2265\u20091000\u2009IU\/mL. Patients with at least three outpatient visits and a minimum follow\u2010up of 12\u2009months were eligible for final analysis. Comprehensive clinical, allergic, immunologic and laboratory assessments were performed to identify aetiologies. Children without an identifiable cause were followed longitudinally and classified according to IgE trajectories and clinical evolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1840 children with markedly elevated IgE levels, 1508 were eligible for final analysis. An aetiologic diagnosis was established in 1449 patients (96.1%), predominantly allergic diseases (97.4%). Only 59 children (3.9%) had unexplained IgE elevation despite extensive evaluation. Over a median follow\u2010up of 27\u2009months, most of these children remained asymptomatic or demonstrated spontaneous declines in IgE levels. However, 13.6% developed new allergic diseases during follow\u2010up. Persistently elevated IgE levels were associated with transient differences in eosinophil counts but not with consistent immunologic abnormalities or severe clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In childhood, markedly elevated total IgE levels almost always reflect an identifiable underlying condition, most commonly atopic disease. Truly unexplained IgE elevation is rare and typically follows a benign course. In the absence of clinical warning signs, careful longitudinal monitoring, rather than aggressive or invasive diagnostic testing, appears to be the most appropriate management strategy, since a minority of these children, particularly those with persistently elevated IgE, go on to develop atopic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70566","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:33:10Z","timestamp":1788417190000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcomes of Paediatric Patients With Unexplained Elevated Total Immunoglobulin E"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2522-9714","authenticated-orcid":false,"given":"\u00c7a\u011fr\u0131","family":"Torun \u00d6zel","sequence":"first","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6897-8396","authenticated-orcid":false,"given":"T\u00fclay Tu\u011f\u00e7e","family":"Kutsal G\u00fcltekin","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Selmano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7648-0352","authenticated-orcid":false,"given":"Zeynep","family":"\u015eeng\u00fcl Emeksiz","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"},{"name":"Department of Paediatric Allergy and Immunology University of Health Sciences  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"Metin","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"},{"name":"Department of Paediatric Allergy and Immunology University of Health Sciences  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emine","family":"Dibek M\u0131s\u0131rl\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"},{"name":"Department of Paediatric Allergy and Immunology University of Health Sciences  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0140-5053","authenticated-orcid":false,"given":"Z\u00fclfikar","family":"Akelma","sequence":"additional","affiliation":[{"name":"Department of Paediatric Allergy and Immunology Ankara Bilkent City Hospital  Ankara T\u00fcrkiye"},{"name":"Department of Paediatric Allergy and Immunology Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University  Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","first-page":"24","article-title":"A Survey of Total IgE Reference Intervals Reported by Scandinavian and British Medical Laboratories\u2014A Need for Harmonisation","volume":"83","author":"Vinnes E. 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