Serum immunoglobulin (Ig) levels of M, G, A, and E were quantitatively measured in 22 patients with active coccidioidomycosis (Group I), 15 patients in clinical remission (Group II), 15 healthy, coccidioidin (CDN) skin-test positive persons (Group III), and 26 healthy, CDN skin-test negative persons (Group IV). Serum IgM levels were comparable in the four study groups. Serum IgG was significantly elevated in patients with active disease (p < 0.001) and those in clinical remission (p < 0.05) and correlated with serum complement-fixing (CF) antibody titers. Serum IgA was elevated in 5 (42%) of 12 patients with active pulmonary disease, 2 (20%) of 10 patients with disseminated coccidioidomycosis, and 1 (7%) of 15 patients in clinical remission. Thirteen (59%) of the 22 patients in Group I and 5 (33%) of those in Group II had an elevated IgE serum level (>200 units/ml). In contrast, 5 (12%) of the 41 healthy subjects in Groups III and IV showed an elevated IgE level. Total serum IgE strongly correlated (p < 0.001) with anti-CDN IgE which, in turn, correlated (p < 0.01) with immediate wheal and flare responses to CDN. There was not, however, a correlation between serum IgE levels (either total or anti-CDN) and disease severity or duration of clinical disease. In addition to anti-CDN IgE, reaginic antibodies were demonstrable to allergens unrelated to Coccidioides immitis. Hyperproduction of IgE in 49% of 37 patients studied may be attributed to a T lymphocyte defect, presumably a T suppressor cell population(s).
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Cox et al. (1979) studied this question.