Korean J Pediatr.  2018 Nov;61(11):348-354. 10.3345/kjp.2018.06324.

Common features of atopic dermatitis with hypoproteinemia

• Jo SY
• Lee CH
• Jung WJ
• Kim SW
• Hwang YH

• KMID: 2433702
• DOI: http://doi.org/10.3345/kjp.2018.06324

Abstract

PURPOSE
The purpose of this study was to identify the causes, symptoms, and complications of hypoproteinemia to prevent hypoproteinemia and provide appropriate treatment to children with atopic dermatitis.
METHODS
Children diagnosed with atopic dermatitis with hypoproteinemia and/or hypoalbuminemia were retrospectively reviewed. The patients' medical records, including family history, weight, symptoms, treatment, complications, and laboratory test results for allergies and skin cultures, were examined.
RESULTS
Twenty-six patients (24 boys) were enrolled. Seven cases had growth retardation; 7, keratoconjunctivitis; 6, aural discharges; 5, eczema herpeticum; 4, gastrointestinal tract symptoms; and 2, developmental delays. In 21 cases, topical steroids were not used. According to the blood test results, the median values of each parameter were elevated: total IgE, 1,864 U/mL; egg white-specific IgE, 76.5 kU(A)/L; milk IgE, 20.5 kU(A)/L; peanut IgE, 30 kU(A)/L; eosinophil count, 5,810/μL; eosinophil cationic protein, 93.45 μg/L; and platelet count, 666.5×10³/μL. Serum albumin and total protein levels decreased to 2.7 g/dL and 4.25 g/dL, respectively. Regarding electrolyte abnormality, 10 patients had hyponatremia, and 12, hyperkalemia. Systemic antibiotics were used to treat all cases, and an antiviral agent was used in 12 patients. Electrolyte correction was performed in 8 patients.
CONCLUSION
Hypoproteinemia accompanying atopic dermatitis is common in infants younger than 1 year and may occur because of topical steroid treatment continuously being declined or because of eczema herpeticum. It may be accompanied by growth retardation, keratoconjunctivitis, aural discharge, and eczema herpeticum and can be managed through skin care and topical steroid application without intravenous albumin infusion.

Keyword

Atopic dermatitis; Hypoproteinemia; Hypoalbuminemia

MeSH Terms

Anti-Bacterial Agents
Arachis
Child
Dermatitis, Atopic*
Eosinophil Cationic Protein
Eosinophils
Gastrointestinal Tract
Hematologic Tests
Humans
Hyperkalemia
Hypersensitivity
Hypoalbuminemia
Hyponatremia
Hypoproteinemia*
Immunoglobulin E
Infant
Kaposi Varicelliform Eruption
Keratoconjunctivitis
Medical Records
Milk
Ovum
Platelet Count
Retrospective Studies
Serum Albumin
Skin
Skin Care
Steroids
Anti-Bacterial Agents
Eosinophil Cationic Protein
Immunoglobulin E
Serum Albumin
Steroids