Hyper-releasability of mast cells in family members of infants with sudden infant death syndrome and apparent life-threatening events.
BACKGROUND
An allergic reaction with increased degranulation of mast cells has been suggested as a possible mechanism in sudden infant death syndrome (SIDS).


METHODS
Mast cell releasability was assessed in 2 study groups: A, 22 subjects, 16 first-degree relatives of infants who had had an apparent life-threatening event (ALTE) and 6 infants after ALTE and B, 46 first-degree relatives of SIDS cases. These groups were compared with 71 members of an age-matched control group. In each subject the skin wheal and flare reactions were measured after an intradermal injection of 0.02 mL of each of the following substances dissolved in phenol-saline solution: histamine 0.0001 mg/mL, histamine 0.001 mg/mL, codeine 0.5 mg/mL, codeine 1 mg/mL, compound 48/80 0.05 mg/mL, compound 48/80 0. 1 mg/mL, and phenol-saline solution. The size of wheal and flare skin reaction was assessed by computerized planimetry after the shape of the cutaneous response was copied onto a paper.


RESULTS
The wheal and flare skin reaction to each of the substances was significantly larger in the 2 study groups compared with the control group (P <.05) except for the wheal reaction to compound 48/80 0.1 mg/mL, codeine 0.5 mg/mL, and histamine in both concentrations for group A and the wheal reaction to codeine 1 mg/mL and histamine in both concentrations for group B. All individuals with increased reaction belonged to 3 (50%) of 6 families with ALTE history and to 8 (73%) of 11 families with SIDS history.


CONCLUSIONS
Increased mast cell hyper-releasability and degranulation take place in family members of some SIDS and ALTE cases and in some infants with ALTE, supporting a possible role for an immunologic mechanism in the pathophysiology of these entities.
Gold
Y
Y
Pediatric Intensive Care Unit and the Clinic for Infants at High Risk, Dana Children's Hospital, Tel-Aviv Medical Center, Israel.
Goldberg
A
A
Sivan
Y
Y
D000328:Adult; D001049:Apnea / Q000209:etiology / Q000235:genetics / Q000276:immunology*; D015550:Cell Degranulation / Q000276:immunology; D002648:Child; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007223:Infant; D008297:Male; D008407:Mast Cells / Q000276:immunology* / Q000502:physiology; D012882:Skin Tests / Q000379:methods / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D013398:Sudden Infant Death / Q000209:etiology / Q000235:genetics / Q000276:immunology*