title: [Case of atopic dermatitis in infant treated with Chinese herbal medicines and nsaids ointment, which induced weight loss, electrolyte disturbance and hypoproteinemia].
abstract: We report here a 4-month-old girl with atopic dermatitis accompanied by weight loss, electrolyte disturbance, hypoproteinemia and hypogammaglobulinemia. She has suffered from eczema since one-month of age. Although she was treated with Chinese herbal medicines, including Syosaikotokakikyosekko, Tokishigyakukagoshuyushokyoto and Jumihaidokuto and ibuprofen ointment since three-month of age, she was referred to our hospital due to deteriorated eczema, severe diarrhea and failure to thrive. Laboratory examination revealed hyponatremia, hyperpotassemia, hypoproteinemia, hypogammaglobulinemia and elevated levels of serum IL-18, TARC and fecal EDN. Drug-induced lymphocyte stimulation tests were positive for the prescribed Chinese herbal medicines. Discontinuation of these medicines and application of steroid ointments improved loose bowels and skin lesions as well as laboratory data. It is suggested that the application of inadequate ointment and Chinese herbal medicines exaggerated inflammation in the skin and the intestinal mucosa leading to electrolyte disturbance, hypoproteinemia and hypogammaglobulinemia. Chinese herbal medicines are depicted as an additional therapy in Japanese guideline for atopic dermatitis, whereas their indication to infants with atopic dermatitis should be carefully assessed.
authors.affiliation: Department of Pediatrics, Faculty of Medical Sciences, University of Fukui.
authors.forename: Motoko
authors.initials: M
authors.lastname: Yasutomi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Okazaki
authors.forename: Akiko
authors.initials: A
authors.lastname: Kawakita
authors.forename: Hisako
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Murai
authors.forename: Mitsufumi
authors.initials: M
authors.lastname: Mayumi
authors.forename: Taizo
authors.initials: T
authors.lastname: Wada
authors.forename: Yusei
authors.initials: Y
authors.lastname: Ohshima
mesh_terms: D000361:Agammaglobulinemia / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D000075202:Contraindications; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000009:adverse effects*; D047208:Eosinophil-Derived Neurotoxin / Q000032:analysis; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D007019:Hypoproteinemia / Q000139:chemically induced*; D007052:Ibuprofen / Q000008:administration & dosage / Q000009:adverse effects*; D007223:Infant; D020382:Interleukin-18 / Q000097:blood; D009824:Ointments; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced*; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D004365:Drugs, Chinese Herbal; D020382:Interleukin-18; D009824:Ointments; D047208:Eosinophil-Derived Neurotoxin; D007052:Ibuprofen