A case of atopic dermatitis in infant treated with chinese herbal medicines and nsaids ointment, accompanied by weight loss, electrolyte disturbance and hypoproteinemia

We report here a 4-month-old girl with atopic dermatitis accompanied by weight loss, electrolyte disturbance, hypoproteinemia and hypogammaglobulinemia. She has suffered from eczema since one-month of age. Although she was treated with Chinese herbal medicines, including Syosaikoto-kakikyosekko. Tokishigyaktikagoshuyushokyoto and Jumihaidokuto and ibuprofen ointment since three-month of age. she was referred to our hospital due to deteriorated eczema, severe diarrhea and failure to thrive. Laboratory examination revealed hyponatremia, hyperpotassemia. hypoproteinemia, hypogammaglobulinemia and elevated levels of serum 11,-18. 'FARC and fecal KDN. Drug-induced lymphocyte stimulation tests were positive for the prescribed Chinese herbal medicines. Discontinuation of these medicines and application of steroid ointments improved loose bowels and skin lesions as well as laboratory data. It is suggested that the application of inadequate ointment and Chinese herbal medicines exaggerated inflammation in the skin and the intestinal mucosa leading to electrolyte disturbance, hypoproteinemia and hypogammaglobulinemia. Chinese herbal medicines are depicted as an additional therapy in Japanese guideline for atopic dermatitis, whereas their indication to infants with atopic dermatitis should be carefully assessed.