We sought to describe the clinical outcomes of eight pediatric patients diagnosed with
atopic dermatitis (AD) and
hypogammaglobulinemia through retrospective review of medical records. All patients presented with severe facial AD. The mean and median ages of diagnosis of
hypogammaglobulinemia were 6.2 months and 6.5 months, respectively, with a mean
immunoglobulin G (
IgG) level of 156 mg/dL. Seven of the eight patients identified in our search demonstrated simultaneous improvement in AD and serum
IgG levels within 2 years of initial presentation, suggesting a diagnosis of transient
hypogammaglobulinemia. The remaining patient demonstrated normalization by age 6, but no
IgG levels had been measured between initial presentation and age 6. The five patients who were tested for specific antibody response to
tetanus and Haemophilus influenzae type b vaccination all produced protective responses. All eight patients initially presented with high serum
IgE levels. On initial evaluation, three patients had
leukocytosis (white blood cell count >18,000 cells/μL), and six had peripheral blood
eosinophilia. Three patients outgrew their AD by age 5, and five had clinically good to excellent control of their AD at their last visit, coincident with normalization of
IgG levels. Although severe AD and
immunoglobulin deficiency may rarely be associated with complex immunodeficiency disorders, our observations suggest that, with careful immunologic monitoring and diligent
skin care, most children who present with severe AD and
hypogammaglobulinemia exhibit improvement in
dermatitis and serum
IgG levels within 2 years of onset without major complications.