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Hyperimmunoglobulin E syndrome

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Alternative Names   

Job syndrome; Hyper IgE syndrome

Definition    Return to top

Hyperimmunoglobulin E syndrome is a suspected genetic defect that produces high levels of the antibody immunoglobulin (IgE). It causes serious skin and lung infections as well as eczema.

Causes    Return to top

Hyperimmunoglobulin E syndrome is also know as Job syndrome, after the biblical character Job whose faithfulness was tested by a lifelong affliction of draining skin sores and pustules. People with this condition have chronic and severe skin infections.

It is an extremely rare disease, and the cause is unknown. However, the bacteria Staphylococcus aureus is believe to most commonly trigger the infections related to the disease. Other common triggers include Streptococcus pneumoniae, Haemophilus influenzae, Candida albicans, and the herpes virus.

Hyper IgE syndrome is, in most cases, inherited in a dominant fashion, meaning that it can run in families with high frequency.

Symptoms    Return to top

Exams and Tests    Return to top

An eye exam may reveal signs of dry eye syndrome. A physical exam may show signs of osteomyelitis, curving of the spine (kyphoscoliosis), and recurrent sinus infections.

A chest x-ray may reveal lung abscesses.

Tests used to confirm a diagnosis include:

Other tests that may be done:

Treatment    Return to top

There is no known cure for the condition. The goal of treatment is to control the recurrent infections. Medications include antibiotic treatment. Antifungal agents and antiviral agents are prescribed when appropriate.

Sometimes, surgical drainage of abscesses is needed.

IV gamma globulin may help to build up the immune system temporarily when there are severe infections.

Outlook (Prognosis)    Return to top

Job syndrome is a lifelong chronic condition. Each new infection requires treatment.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you are experiencing or observing a collection of the above signs and symptoms.

Prevention    Return to top

There is no proven prevention. Good general hygiene is helpful. Some doctors may recommend preventive antibiotics for people with many infections, particularly with Staphylococcus aureus. This does not change the underlying disorder but rather its consequences.

References    Return to top

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004.

Hoffman R, Benz EJ, Shattil SS, et al. Hematology: Basic Principles and Practice. 4th ed. Orlando, Fl: Churchill Livingstone; 2005.

Update Date: 7/25/2007

Updated by: Donald Accetta, MD, MPH, President, Allergy & Asthma Care, PC, Taunton, MA. Review provided by VeriMed Healthcare Network.

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