Editor,—Hyperimmunoglobulin E syndrome (HIES) is a rare primary immunodeficiency defined by recurrent infections and markedly elevated serum immunoglobulin E (IgE) concentration. Because the primary defect in HIES is unknown, there is no specific treatment. In few cases, continuous treatment with trimethoprim sulfamethoxazole, recombinant interferon gamma or cyclosporin A have been used to reduce the serum IgE levels (up to 20%, 55%, and 95%, respectively).1 ,2 However, adverse effects with such long term treatments have been described in children with HIES.2

We report the …