Recurrent giant chalazia in hyperimmunoglobulinemia E (Job's) syndrome

Purpose: To report a case of recurrent, multiple giant chalazia in a patient with hyperimmunoglobulinemia E (Job's) syndrome, a rare autosomal dominant disorder characterized by markedly increased immunoglobulin E levels and recurrent pulmonary and skin infections. Methods: A 50-year-old man was referred with a 4-year history of recurrent, multiple giant chalazia in all eyelids. Medications and surgical intervention produced only transient improvement. The patient also had a history of pulmonary and scalp infection. Results: Laboratory tests disclosed elevated plasma immunoglobulin E (> 500 IU/ml) and eosinophilia. As a result, based on clinical and laboratory findings, a diagnosis of hyperimmunoglobulinemia E (Job's) syndrome was made. Conclusions: Even though rarely, recurrent multiple giant chalazia may occur as an ophthalmic feature of the Job's syndrome. The hyperimmunoglobulinemia E syndrome should be suspected in any case of recurrent giant chalazia. Measurament of plasma immunoglobulin E and eosinophils, along with internal evaluation, are essential to establish a proper diagnosis.