ESPE Abstracts

Introduction: Skin barrier defects play central role in the pathogenesis of atopic dermatitis (AD) affecting local immunity and skin hydration. Severe AD may deleteriously affect growth and nutrition in these children.

Objectives: To 1) measure the effect of AD on linear growth in infants and children 2) to study the effect of hypoalbuminemia and hypo-proteinemia on the growth of these children.

Methods: We studied linear growth and BMI all children with severe AD (<14 years) (n=162) seen at Ped Allergy-Immunology clinics of Hamad General Hospital during June 2014–2015 with severe AD. SCORAD and anthropometric data were collected Serum total protein, albumin, 25OHD, and IgE concentrations were measured.

Results: Children with severe AD had height SDS (HtSDS) =−0.75±0.8. 22/162 (13.60%) of children had HtSDS < −2, 57/162 (35%) had HtSDS < −1. BMI of the patients =15±6.4. BMISDS was < −2 in 14% of patients. 16% of patients had hypoalbuminemia. AD severity scores (SCORAD) was 61.3±22.3. Twenty six patients with hypoalbuminemia had low BMI 11.2±2% compared to 26 normo-albuminemic patients who had BMI 19.1±38.1%. SCORAD was higher in hypo-albuminemic-low-BMI patients compared to normo-albuminemic-normal-BMI patients (67.9±22.1 vs 58.3±22.5). Vitamin D deficiency was found in 58% of the patients. HtSDS and BMI did not correlate significantly with the severity of the disease (SCORAD).

Conclusions: Children with severe AD had high prevalence of hypoalbuminemia due to loss of albumin through the diseased skin. Albumin loss may lead to malnutrition and low BMI in these patients. HtSDS of 35% of children was <−1. It is important to closely monitor growth, nutrition and biochemical makers in the management of severe AD.