Risk factors for infantile atopic dermatitis and recurrent wheezing

BACKGROUND

The pathogenic mechanisms of atopic dermatitis (AD) and recurrent wheezing (RW) during infancy are not fully understood.

OBJECTIVE

We evaluated immunological markers associated with AD and RW during infancy.

METHODS

We followed a cohort (n = 314) from birth to 14 months of age. Some of the participants underwent a physical examination and blood test at 6 and 14 months of age. Univariate and multivariate logistic regression analysis and receiver operating characteristic curve analysis were performed to find which immunological markers could be risk factors for AD and RW.

RESULTS

Of 16 immunological markers found in cord blood, only immunoglobulin (Ig) E was associated with AD at 6 months of age (adjusted OR [aOR], 1.607). None of the markers was associated with AD or RW at 14 months of age. Of 23 immunological markers at 6 months of age, total IgE (aOR, 1.018) and sensitization to egg white (aOR, 23.246) were associated with AD at 14 months of age. Phytohemagglutinin (PHA)-induced production of interleukin (IL) 4 from peripheral blood mononuclear cells (PBMCs) (aOR, 1.043) was associated with RW at 14 months of age.

CONCLUSION

Cord blood IgE was a risk factor for AD at 6 months of age. Total IgE and sensitization to egg white at 6 months of age were risk factors for AD at 14 months of age. PHA-induced IL-4 production in PBMCs at 6 months of age was a risk factor for RW at 14 months of age.

Protein-losing enteropathy associated with egg allergy in a 5-month-old boy

Protein-losing enteropathy (PLE), the manifestation of a diverse set of disorders, is characterized by excessive loss of plasma proteins into the affected portions of the gastrointestinal tract, and this results in hypoalbuminemia. A 5-month-old breastfed boy presented severe PLE with hypogammaglobulinemia, hypocalcemia, and hypomagnesemia induced by an egg allergy. He developed hypocalcemic convulsions. The diagnosis of PLE was confirmed by elevated fecal alpha1-antitrypsin clearance and a positive finding on a protein-losing scintigram. His allergy to egg delivered through maternal milk was confirmed as the cause of PLE, since the mother's elimination of egg from her diet improved his condition and maternal egg challenge provoked symptoms of diarrhea, vomiting, and elevated alpha1-antitrypsin clearance. At the time of writing, he is 22 months old and has experienced no further episodes after the elimination of egg-containing food.