2022 Volume 34 Issue 1 Pages 37-40
Children with Netherton syndrome are likely to be sensitized to multiple allergens due to skin barrier dysfunction. Owing to substantial increases in total and food allergen-specific IgE levels, some children with Netherton syndrome are diagnosed with food allergies （FAs） and advised to avoid particular foods. However, it is unclear whether such children actually have FAs. We report a child with Netherton syndrome without atopic dermatitis （AD） who was able to stop avoiding certain foods （hens’ eggs and peanuts） after undergoing oral food challenge （OFC）. A 5-year-old Japanese boy with Netherton syndrome without AD consulted at our hospital to evaluate the possibility of allergies to hens’ eggs and peanuts. Netherton syndrome had been diagnosed at birth. At 1 year old, the levels of specific IgE for egg white and peanuts were ＞100 and 14.6kU/l, respectively. He had not consumed or experienced allergic symptoms to these foods. However, he was instructed to completely avoid these foods in his diet. At 5 years old, he still completely avoided these foods. The levels of specific IgE for egg white, ovomucoid, and peanuts were 34.5, 9.4, and 17.4kU/l, respectively. Since the serum-specific IgE levels and the serum-specific IgE/total IgE ratio decreased, we performed OFCs for hens’ eggs and peanuts. The results of the OFCs using half a baked egg and 10g of peanuts were all negative. The same dosing schedule was repeated at home, again with negative results. Therefore, the avoidance could be stopped. This report suggests that we should identify whether patients have AD or not, and OFCs should be performed before requesting food restriction in patients with Netherton syndrome.
