Hypereosinophilia, hyper-IgE syndrome, and atopic dermatitis in a toddler with food hypersensitivity.
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.
Estrada-Reyes
E
E
Hospital Angeles Metropolitano, México DF, Mexico. elizabeth.estradareyes@gmail.com
Hernnández-Román
M P
MP
Gamboa-Marrufo
J D
JD
Valencia-Herrera
A
A
Nava-Ocampo
A A
AA
D001379:Azathioprine / Q000627:therapeutic use; D001856:Bone Marrow Examination; D002469:Cell Separation; D003131:Combined Modality Therapy; D003876:Dermatitis, Atopic / Q000150:complications* / Q000178:diet therapy / Q000188:drug therapy / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D005512:Food Hypersensitivity / Q000150:complications* / Q000178:diet therapy / Q000276:immunology; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications* / Q000276:immunology; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D007589:Job Syndrome / Q000150:complications* / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use
D007136:Immunoglobulins; D001379:Azathioprine; D011241:Prednisone