Cedar Pollen Aggravates Atopic Dermatitis in Childhood Monozygotic Twin Patients with Allergic Rhino Conjunctivitis

We report a case of 7-year-old monozygotic twin patients with atopic dermatitis. The HLA haplotypes were HLA A2, A11, B27, B61, DR1, and DR4. Both serum IgE levels and cedar pollen radioallergosorbent test (RAST) scores were high in the twins (elder/younger sister: IgE: 5170/3980 IU/ml and Japansese...

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Bibliographic Details
Published in:Allergology international 2011, Vol.60 (3), p.397-400
Main Authors: Murakami, Yukako, Matsui, Saki, Kijima, Akiko, Kitaba, Shun, Murota, Hiroyuki, Katayama, Ichiro
Format: Article
Language:English
Subjects:
Allergens - immunology
Anti-Allergic Agents - therapeutic use
atopic dermatitis
cedar pollen
Child
childhood
Conjunctivitis, Allergic - complications
Cryptomeria - immunology
Dermatitis, Atopic - complications
Dermatitis, Atopic - diagnosis
Dermatitis, Atopic - immunology
Dermatitis, Atopic - therapy
Diseases in Twins - complications
Diseases in Twins - diagnosis
Diseases in Twins - immunology
Diseases in Twins - therapy
Female
Haplotypes
HLA Antigens - genetics
Humans
Immunoglobulin E - blood
Immunoglobulin E - immunology
monozygotic twins
Pollen - immunology
Rhinitis, Allergic, Seasonal - complications
Rhinitis, Allergic, Seasonal - diagnosis
Rhinitis, Allergic, Seasonal - immunology
Rhinitis, Allergic, Seasonal - therapy
scratching behavior
Skin - pathology
Twins, Monozygotic
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Summary:We report a case of 7-year-old monozygotic twin patients with atopic dermatitis. The HLA haplotypes were HLA A2, A11, B27, B61, DR1, and DR4. Both serum IgE levels and cedar pollen radioallergosorbent test (RAST) scores were high in the twins (elder/younger sister: IgE: 5170/3980 IU/ml and Japansese cedar pollen: >100/64.0) in contrast to low mite and food RAST scores (Dermatophagoides Pterygonium; 0.59/0.4 and egg white 9.24/4.6). The patients showed positive immediate (20 min in both sisters) and delayed (24 hours in elder sister, 24, 48, 72 hours in younger sister) reactions to a scratch test with Japanese cedar pollen. Skin lesions on the face were aggravated and extended to the trunk and extremities during the Japanese cedar pollen season and gradually subsided in summer. Oral provocation with egg white or cow milk showed no exacerbations, and topical corticosteroid did not improve the eczema. In contrast, successful protection from severe scratching behaviors was achieved by use of topical anti-allergic eye drops and wearing nightgowns made by the mother.
ISSN:1323-8930
1440-1592
DOI:10.2332/allergolint.10-CR-0268