title: Agammaglobulinemia and lack of immunization protection in exudative atopic dermatitis.
abstract: Atopic dermatitis is very frequent in the first 6 months of life, and the severe exudative form of this skin disorder is by no means rare. Failure to achieve immunization protection is a potentially life-threatening complication of exudative atopic dermatitis that may go unrecognized. We report the case of a 6-month-old infant with severe exudative atopic dermatitis in whom hypoproteinemia and agammaglobulinemia were attributed to the massive exudation after exclusion of other possible causes. The patient failed to respond to standard immunization, and adequate protection with a good antibody response could be achieved only after exudation from the skin lesions had been treated by intensive topical skin therapy and multiple intravenous immunoglobulin substitution. Two otherwise similar earlier case reports did not investigate the immune status. Therefore, to the best of our knowledge, this is the first report to draw attention to absence of immunization protection in exudative atopic dermatitis.
  
  
  CONCLUSIONS
  We hope that our case report will motivate pediatricians to check the immunization status of patients with exudative atopic dermatitis and take the necessary steps to improve their care.
authors.affiliation: Department of Pediatric Oncology, Hematology and Clinical Immunology, Center of Child and Adolescent Health, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany, petra.lankisch@med.uni-duesseldorf.de.
authors.forename: Petra
authors.initials: P
authors.lastname: Lankisch
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Laws
authors.forename: Michael
authors.initials: M
authors.lastname: Weiss
authors.forename: Arndt
authors.initials: A
authors.lastname: Borkhardt
mesh_terms: D000361:Agammaglobulinemia / Q000209:etiology* / Q000628:therapy; D003876:Dermatitis, Atopic / Q000209:etiology* / Q000628:therapy; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007019:Hypoproteinemia / Q000150:complications*; D017589:Immunization Programs; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007223:Infant; D014612:Vaccines / Q000008:administration & dosage
chemical_list: D016756:Immunoglobulins, Intravenous; D014612:Vaccines