Total immunoglobulin E refers to the amount of immunoglobulin E in human serum. Immunoglobulin E is one of the human immunoglobulins and is usually one of the five immunoglobulins with relatively low levels. Elevated levels of total immunoglobulin E in serum may be seen in patients with allergies or allergic reactions, including parasitic infections, and in patients with multiple myeloma. Decreased total immunoglobulin E may be seen in patients with primary or secondary immunoglobulin deficiency, chronic lymphocytic leukemia, silicosis, and asbestosis.