IGHE and allergic disease: Chronic autoimmune urticaria (CAU) can be found in 45% of such cases, with antibodies against the high-affinity IgE receptor (IgEfcR) or IgE.1, 2 The causal role of IgE in allergic disease is well established.3 The allergic cascade is initiated when IgE bound to high-affinity FceRI receptors on the surface of basophils and mast cells is cross-linked by allergen, resulting in degranulation of effector cells and release of histamine and leukotrienes.