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Published on: September 20, 2018
[Clinical features of severe infant atopic dermatitis with hypoproteinemia]
Masayuki Akashi1, Ichiro Nomura, Akemi Saito
1Division of Allergy, National Center for Child Health and Development.
Insights
Severe infant atopic dermatitis (AD) can cause hypoproteinemia, growth impairment, and electrolyte issues. Prompt treatment with skincare, topical steroids, and allergen removal effectively improves symptoms and lab findings in these patients.
Area of Science:
- Pediatric Dermatology
- Clinical Immunology
Context:
- Severe atopic dermatitis (AD) in infants can present with serious complications.
- Hypoproteinemia and growth impairment have been sporadically reported in infants with severe AD.
Purpose:
- To characterize initial clinical findings of infants with severe atopic dermatitis (AD) and hypoproteinemia.
- To analyze the treatment course and outcomes for these patients.
Summary:
- A study of 119 infants with AD identified 15 cases of severe AD with hypoproteinemia.
- These infants exhibited growth impairment (height/weight < 3rd percentile), electrolyte abnormalities (hyponatremia/hyperpotassemia), and thrombocytosis.
- Treatment involving skincare, topical steroids, and allergen avoidance led to rapid improvement in symptoms and laboratory markers.
Impact:
- Highlights the potential systemic complications of severe infant AD, including hypoproteinemia, growth issues, electrolyte imbalances, and thrombocytosis.
- Demonstrates that appropriate and timely treatment can effectively manage these severe manifestations of atopic dermatitis.
Objective:
In recent years, there have been sporadic reports of severe atopic dermatitis (AD) with hypoproteinemia and growth impairment. The present study was conduced in order to ascertain the characteristics of patients with severe infant AD with hypoproteinemia at the initial visit and their treatment courses.
Subjects:
Of AD patients younger than 1 year of age who visited the department over a 27-month period from March 2002, subjects were those with severe AD accompanied by hypoproteinemia. The clinical characteristics of these patients at the initial visit and the changes in symptoms and laboratory findings were statistically analyzed.
Results:
Of the total of 119 AD patients younger than 1 year of age visited to the department during the above-mentioned period, 15 patients had severe AD with hypoproteinemia. The height and body weight of approximately half of the patients were less than 3rd percentile, and 10% and more of the patients had severe hyponatremia or hyperpotassemia. The platelet count for 60% of the patients exceeded 800 x 10(3)/microl. After visiting the department, therapy involving the use of skin care products and topical steroids and the removal of exacerbation factors quickly improved dermal symptoms and laboratory findings.
Conclusion:
Severe AD is a disease that should be cautiously treated because of the risk of hypoproteinemia, growth impairment, electrolyte abnormalities, and thrombocytosis; however, it should be noted that appropriate treatments can improve this condition.
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