CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
THURSDAY, 10:15-11:00 AM
Kelly A, Cady R, Ireland M, Khan K.
High prevalence of allergic disorders and subtle immune
abnormalities in children with complex medical problems.
Division of General Pediatrics and Adolescent
Health, Departments of Pediatrics, University of Minnesota kelly045@umn.edu
PURPOSE: Allergic diseases are increasing worldwide
and have been associated with immune dysregulation. We studied children
with complex medical problems (CCMP) to determine the prevalence of
allergies and immune dysregulation.
METHOD: A retrospective study of a convenience
sample 42 children with complex medical problems was conducted. Medical
records and laboratory data were reviewed for clinical characteristics,
allergies, and immunology investigations.
RESULTS: Forty children (95%) had one or more
type of allergy. Allergy to cow's milk was present in 32 (76%). Abnormal
immunoglobulin levels were present for IgG, IgA, and IgE at a frequency
greater than expected for the general pediatric population (p<.005).
Lymphocyte subset percentages were decreased (p<.05) for B cells (CD19)
and natural killer cells (CD57 and CD16/56). Failure to thrive, developmental
delay, sleep disturbance and recurrent otitis media were present in
the majority of study participants. Presence of a gastrostomy tube,
gastro-esophageal reflux disease, chronic gastric acid suppression,
and chronic constipation were common gastrointestinal features.
CONCLUSION: We report a higher than expected
incidence of allergies and immune dysregulation in CCMP. High exposure
to cow's milk via gastrostomy tube, altered gastric pH and changes in
the intestinal microbial environment may be contributing to the allergies
and immune abnormalities. The pathogenesis and development of allergies
among CCMP may advance our understanding of interactions between intestinal,
neural and immune mechanisms. At the very least, it suggests that immune
dysregulation may play a role in the chronic symptoms children with
CCMP suffer (e.g. sleep disturbance, oral aversion, intestinal dysmotility,
failure to thrive).
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