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Background: Although allergic diseases occur through IgE-mediated reaction, about 20% of allergic asthmatics have normal total serum IgE levels. Objective: To characterize the allergic asthmatics with normal total serum IgE levels. Method: Medical records of 430 consecutive allergic asthmatics, who received the tests for both total IgE and allergen-specific IgE in the serum or on the skin, were reviewed. According to the total and specific IgE levels, the subjects were classified to 4 groups (I, increased/strong; Ⅱ, normal/strong; Ⅲ, increased/weak; Ⅳ, normal/weak). Result: The Dermatophagoides farinae-specific IgE level in the serum was significantly related to the total serum IgE level (r=0.322, P<0.001). The D. farinae-specific IgE le- vels were significantly lower in the group Ⅱ than in the group Ⅰ (3.27±0.14 vs. 1.83±0.30, P<0.01) and the group Ⅳ than in the group Ⅲ (0.79±0.05 vs. 0.44±0.13, P<0.01). The results for D. pteronyssinus and sum of checked allergens were similar. The proportion of the patients sensitized to single allergen to total subjects was 7.5%/13.5%/ 33.0%/40.0% for Ⅰ/Ⅱ/Ⅲ/Ⅳ groups (χ2=44.5, P<0.001). Conclusion: The allergic asthmatics with normal total serum IgE levels had lower allergen-specific IgE levels and a higher proportion of the patients sensitized to single allergen. The levels of total serum IgE may be determined by the degree of sensitization in allergic asthma.

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