Hyper-IgE syndrome: Two Egyptian case reports - Abstract
Hyper-IgE syndromes (HIES) are a heterogeneous group of inborn errors of immunity. The
underlying cause of HIES is dominant mutations in various signal transduction and activators of
transcription genes with the most common type is mutation in the STAT3 gene located on chromosome
17 followed by mutation in DOCK8 gene. The disease is very rare with prevalence less than 1 per
million population. Elevated IgE level is the cardinal feature of the disease. Clinical features include
recurrent eczema, frequent bacterial infections, and mucocutaneous candidiasis.
Treatment is usually symptomatic including prophylactic antibiotics. Bone marrow
transplantation & stem cell therapy can be used for recalcitrant cases.
Recently, biologics have emerged as an additional option for treating HIES with treatment
refractory atopic dermatitis. Dupilumab, a human monoclonal antibody that blocks the shared
receptor subunit of IL-4 and IL-13, mitigates the signs and symptoms of atopic dermatitis. Few case
reports have demonstrated the substantial improvements of atopic dermatitis following the injection
of dupilumab in HIES.
Here, we present two cases of different age groups whom atopic dermatitis was treated
successfully using dupilumab, an IL-4 / IL-13 antagonist.