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Case History - Section 1

An adverse reaction to food is best referred to as food hypersensitivity. However, when immunological mechanisms have been demonstrated the appropriate term is food allergy.

When the role of IgE has been demonstrated, the term is IgE-mediated food allergy.

This case history focuses on IgE-mediated food allergy from infancy to 16 years of age.

James is now 16 years old.

He first presented at 8 months with severe atopic eczema (atopic dermatitis).

James was born full term and was breast fed exclusively for 6 months.

Atopic eczema commenced at 6 weeks and became generalized and severe. He was a colicky, unsettled baby.

Solids were introduced at 6 months beginning with rice cereal with some cow's milk formula. His atopic eczema worsened significantly at this stage.



Answer: Cell-mediated dysfunction

THIS IS INCORRECT - An important consideration since patients with atopic eczema are prone to develop a variety of infectious diseases of fungal, viral or bacterial origin like candidiasis, eczema herpeticatum (Kaposi's varicelliform eruption), or staphylococcal impetigo, defective cellular immunity has been suspected.

The hypothesis of a lower prevalence of T cell-mediated contact allergy in atopic eczema has recently been questioned. Rather, these patients show a different contact allergen spectrum compared to individuals lacking the atopic constitution (metal allergy more frequent; lanolin, fragrance, etc. less frequent).

For further information on the causes of atopic eczema in children access the references below:

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