Children with AD often have a fatty liver.
Fatty liver in atopic dermatitis†
Article first published online: 15 JAN 2002
Volume 56, Issue 5, page 460, May 2001
How to Cite
Kimata, H. (2001), Fatty liver in atopic dermatitis. Allergy, 56: 460. doi: 10.1034/j.1398-9995.2001.056005460.x
- Issue published online: 15 JAN 2002
- Article first published online: 15 JAN 2002
- Accepted for publication 6 February 2001
- atopic dermatitis;
- fatty liver;
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritis and elevated serum IgE levels.It has been reported that liver dysfunction is sometimes found in children with AD (1),and the case of a child with severe AD and fatty liver was reported, although this was most probably due to malnutrition (2). I have studied the serum levels of total cholesterol and LDL-cholesterol, and conducted abdominal ultrasound scans in pediatric patients under 14 years of age with AD but without malnutrition.
As Table 1 shows, 357 patients with AD, who had clinical features of moderate to severe AD by Hanifin & Rajka's grading and by our skin scoring system(3, 4), were studied. Malnourished patients were excluded. A total of 344 age-matched, nonatopic children, 118patients with bronchial asthma (BA),and 85 patients with allergic rhinitis(AR) were included as controls after informed consent was obtained. None of them were obese. Significantly elevated levels of serum total cholesterol(>220 mg/dl) and/or LDL-cholesterol (>120 mg/dl) were found in 27.7%of AD patients compared to 10.1–12.2%of controls (P<0.05). They were further studied for the presence of fatty liver by abdominal ultrasound scans, and fatty liver was graded as mild, moderate, or severe (5). Fatty liver was found in 17.6% (P<0.05) of AD patients and in 3.2–5.0% of controls. Surprisingly, in AD, 9/99 patients with fatty liver, although classified as mild cases, were under 1 year, and the youngest patient was 0.5 years old. In contrast, in the control subjects, all of those with fatty liver were more than 2 years old. Percentages of both mild and moderate fatty liver were higher in AD patients than in control subjects. Severe fatty liver was not found in either of the groups. Moreover, the severity of fatty liver was not associated with liver dysfunction in that the serum levels of GOT and GPT were within normal limits in most of the patients with fatty liver.
|Controls||Bronchial asthma||Allergic rhinitis||Atopic dermatitis|
|Range of age (years)||0.4–13.9||0.9–13.5||1.0–13.8||0.4–14.0|
|Mean age (years)||4.9||5.3||5.4||4.5|
|Number of subjects with|
|Elevated cholesterol*||35 (10.1%)**||13 (11.2%)||10 (12.2%)||99 (27.7%)|
|Fatty liver||11 (3.2%)||6 (5.0%)||3 (3.7%)||63 (17.6%)|
|Mild||10 (2.9%)||5 (4.2%)||3 (3.7%)||55 (15.4%)|
|Moderate||1 (0.3%)||1 (0.8%)||0 (0.0%)||8 (2.2%)|
The mechanisms of fatty liver in AD are currently under investigation. However, high percentages of fatty liver in AD, but not in control subjects, BA patients, or AR patients suggest that fatty acid dysregulation may be involved in the pathogenesis of AD (6). These results indicate that children with AD should be examined for fatty liver.
- 3Diagnosis features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 1980;92:44–47.& .
- 5Sonographic diagnosis of fatty liver using a histogram technique that compares liver and renal cortical echo amplitudes. J Clin Ultrasound 1996;24:25–29.DOI: 10.1002/(sici)1097-0096(199601)24:1<25::aid-jcu4>3.0.co;2-n& .