PMID- 17498216
OWN - NLM
STAT- MEDLINE
DCOM- 20071024
LR  - 20181113
IS  - 0019-2805 (Print)
IS  - 1365-2567 (Electronic)
IS  - 0019-2805 (Linking)
VI  - 122
IP  - 1
DP  - 2007 Sep
TI  - Hypogammaglobulinaemia secondary to cow-milk allergy in children under 2 years of 
      age.
PG  - 140-6
AB  - Symptomatic hypogammaglobulinaemia in children younger than 2 years of age was 
      studied to rule out a primary immunodeficiency. Thirty-four patients were 
      referred to the Immunology Service to study the hypogammaglobulinaemia-associated 
      clinical picture. Food allergy was documented in 10 patients by personal and 
      familial history, presence of specific immunoglobulin E (IgE) and elevated total 
      serum IgE levels. Coeliac disease and human immunodeficiency virus infection were 
      also ruled out. Protein loss through stools was assessed by clearance of 
      alpha1-antitrypsin (AAT). Serum immunoglobulin levels were determined by 
      nephelometry and functional antibodies were studied by enzyme-linked 
      immunosorbent assay. The cellular immune response was assessed by in vitro 
      lymphocyte proliferation in response to mitogens and cell subsets were analysed 
      by flow cytometry. In five patients of the 10 patients we suspected a protein 
      loss through the mucosa. Four of these five patients showed an increased AAT and 
      the other showed an extensive cutaneous lesion. Immunological studies revealed 
      normal antibody function, in vitro lymphoproliferative responses and cell numbers 
      in four of the 5 patients. One patient showed abnormally low numbers of CD4(+) T 
      cells as well as a defective proliferative response to mitogens. After diagnosis 
      of cow milk allergy, milk was replaced with infant milk formula containing 
      hydrolysed proteins. Recovery of immunoglobulin values and clinical resolution 
      were achieved. Hypogammaglobulinaemia during early childhood in some children may 
      be secondary to cow milk allergy, and immunoglobulins and cells may leak through 
      the inflamed mucosa. Resolution of symptoms as well as normalization of 
      immunoglobulin values may be easily achieved by avoidance of the offending 
      allergen.
FAU - Bezrodnik, Liliana
AU  - Bezrodnik L
AD  - Servicio de Inmunologia, Hospital de Ninos Dr Ricardo Gutierrez, Buenos Aires, 
      Argentina. lbezrodnik@intramed.net.ar
FAU - Raccio, Andrea C Gomez
AU  - Raccio AC
FAU - Canil, Laura M
AU  - Canil LM
FAU - Rey, Maria Amanda
AU  - Rey MA
FAU - Carabajal, Patricia C
AU  - Carabajal PC
FAU - Fossati, Carlos A
AU  - Fossati CA
FAU - Docena, Guillermo H
AU  - Docena GH
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070511
PL  - England
TA  - Immunology
JT  - Immunology
JID - 0374672
RN  - 0 (Immunoglobulins)
RN  - 0 (alpha 1-Antitrypsin)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Agammaglobulinemia/*etiology/immunology
MH  - Cells, Cultured
MH  - Feces/chemistry
MH  - Humans
MH  - Immunity, Cellular
MH  - Immunoglobulin E/blood
MH  - Immunoglobulins/blood
MH  - Infant
MH  - Infant, Newborn
MH  - Milk Hypersensitivity/*complications/diet therapy/immunology/metabolism
MH  - Skin Tests
MH  - alpha 1-Antitrypsin/metabolism
PMC - PMC2265992
EDAT- 2007/05/15 09:00
MHDA- 2007/10/25 09:00
PMCR- 2008/09/01
CRDT- 2007/05/15 09:00
PHST- 2007/05/15 09:00 [pubmed]
PHST- 2007/10/25 09:00 [medline]
PHST- 2007/05/15 09:00 [entrez]
PHST- 2008/09/01 00:00 [pmc-release]
AID - IMM2628 [pii]
AID - 10.1111/j.1365-2567.2007.02628.x [doi]
PST - ppublish
SO  - Immunology. 2007 Sep;122(1):140-6. doi: 10.1111/j.1365-2567.2007.02628.x. Epub 
      2007 May 11.