The Classification between IgE and Non-IgE Mediated Atopic Dermatitis in Korean Children / 소아알레르기및호흡기학회지

PURPOSE: Atopic Dermatitis (AD) is a chronically relapsing inflammatory skin disease. Generally, aeroallergens and food allergens can exacerbate symptoms in AD. Currently they are divided into two groups: one is an IgE mediated form and the other is a non-IgE mediated form. This study focused upon clinical manifestations of two distinct forms of AD. METHODS: We evaluated 110 patients (male: 58, female: 52) with AD. All patients had visited Masan Samsung Hospital from June 2002 to February 2005. The patients were divided into 2 sub-groups according to their serum total IgE and specific IgE levels. The serum total IgE and specific IgE to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Egg white, Cow's milk and Soybean were measured by the Pharmacia CAP-FEIA system. Metacholine provocation tests were conducted to reveal bronchial hyper-responsiveness and ARIA guidelines for diagnosis of AR were applied. RESULTS: Our study showed more female predominance in non IgE-mediated atopic dermatitis patients and showed higher total eosinophil count in IgE-mediated atopic dermatitis. (P 0.05), but allergic rhinitis was significantly predominant in non IgE-mediated atopic dermatitis patients. (P< 0.05) CONCLUSION: Female was more predominant in non IgE-mediated atopic dermatitis patients and IgE-mediated atopic dermatitis patients showed higher total eosinophil count and more frequency of allergic rhinitis.

Anaphylaxis to Curry Powder in Childhood / 소아알레르기및호흡기학회지

A 15-year old boy visited Samsung Medical Center complaining that when he ate curry and rice two months ago, he developed immediate palatal itching, generalized urticaria, headache and dyspnea. His chest radiographs were normal. He had no history of allergy, but a methacholine provocation challenge test revealed positive findings (PC20 3.62 mg/mL). Skin prick tests revealed positive findings to asparagus, house dust mites (Dp, Df), flower pollens (aster, chrysanthemum, golden rod), weed pollens (mugwort, ragweed, dandelion, short ragweed) and crude extract of curry powder. Specific IgE to Dp, Df and soy bean were positive (6.52, 31.2 and 1.91 kU/L) and total IgE was 1, 207 kU/L by the Pharmacia UniCAP- FEIA. After receiving parental consent, we performed an oral provocation test to confirm the relationship between his symptoms and curry powder. He ingested a small amount of curry powder with pure water, which was increased every 1 hour. We then measured his PEFR every 10 minutes after each subsequent curry powder ingestion. After he ate 20 gm of curry powder in one time, he exhibited profuse sweating, skin rash and dyspnea. When we treated him with epinephrine and bronchodilator, his symptoms improved. He developed the same symptoms 2 hours later, but these symptoms were brought under control by the same medication.