Hypereosinophilia, hyper-IgE syndrome, and atopic dermatitis in a toddler with food hypersensitivity.

Abstract

We describe a 20-month-old girl with hypereosinophilia, hyper-immunoglobulin (Ig) E syndrome, and atopic dermatitis. Her peripheral eosinophil count and IgE plasma levels were 2.65 x 10(9)/L and 6702 IU/mL, respectively. Specific IgE levels for a variety of foods and inhalants were high and single-blind food challenges were positive for cow's milk, hen's egg, oat, wheat, and soy. When the patient received an extensively hydrolyzed milk formula, an exclusion diet, and 2 mg/kg of prednisone daily, the atopic dermatitis partially improved. Further improvement was observed with 1 mg/kg of azathioprine daily. Long-term clinical response was satisfactory. We suggest that food hypersensitivity should be ruled out in patients with hypereosinophilia, hyper-IgE syndrome, and atopic dermatitis. Azathioprine may be a good therapeutic alternative for treatment in such cases.

• Authors: E Estrada-Reyes, M P Hernnández-Román, J D Gamboa-Marrufo, A Valencia-Herrera, A A Nava-Ocampo
• Journal: Journal of investigational allergology & clinical immunology (J Investig Allergol Clin Immunol) Vol. 18 Issue 2 Pg. 131-5 ( 2008) ISSN: 1018-9068 [Print] Spain
• PMID: 18447144 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins
• Azathioprine
• Prednisone

Topics

• Azathioprine (therapeutic use)
• Bone Marrow Examination
• Cell Separation
• Combined Modality Therapy
• Dermatitis, Atopic (complications, diet therapy, drug therapy, immunology)
• Diagnosis, Differential
• Female
• Flow Cytometry
• Food Hypersensitivity (complications, diet therapy, immunology)
• Humans
• Hypereosinophilic Syndrome (complications, immunology)
• Immunoglobulins (blood)
• Infant
• Job Syndrome (complications, immunology)
• Prednisone (therapeutic use)