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Case Report
 

Hypereosinophilia, Hyper-IgE Syndrome, and Atopic Dermatitis in a Toddler With Food Hypersensitivity
 

E Estrada-Reyes,1 MP Hernández-Román,1 JD Gamboa-Marrufo,2 A Valencia-Herrera,3 AA Nava-Ocampo4,5

1Hospital Angeles Metropolitano, México DF, Mexico
2Departament of Internal Medicine, Hospital Infantil de México Federico Gómez, México DF, Mexico
3Service of Dermatology Hospital Infantil de México Federico Gómez, México DF, Mexico
4Divison of Clinical Pharmacology & Toxicology, Hospital for Sick Children, Toronto, Canada
5PharmaReasons, Toronto, Canada

J Investig Allergol Clin Immunol 2008; Vol. 18(2): 131-135
 

 Abstract


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 2.65 109/L and 6702 IU/mL, respectively. Specifi c 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.

Key words: Atopic dermatitis. Food allergy. Hypereosinophilia. Hyper-IgE syndrome. Immunological diagnosis.