Clinical Significance of Atopic Dermatitis with Hypoalbuminemia in Korean Children

Background Hypoalbuminemia can be a life-threatening complication of severe atopic dermatitis (AD). Objectives The aim of this study was to evaluate correlations between clinical features and laboratory tests of AD children with scoring atopic dermatitis (SCORAD) scores ≥ 40, according to the presence of hypoalbuminemia. Methods Children with AD between 3 and 24 months of age with SCORAD score ≥ 40 (n = 82), admitted to our unit from June 2007 to March 2016, were categorized to two groups of hypoalbuminemic (n = 27) and non-hypoalbuminemic (n = 55). A blood albumin level of ≤ 3.5 g/d on the first day of admission was considered as hypoalbuminemia. The results of clinical and laboratory tests of the two groups were evaluated and compared. Results Significant differences were observed in different genders, age at AD onset, and duration of AD between the groups. Compared with non-hypoalbuminemia group, significantly more patients in hypoalbuminemia group had positive test results for methicillin-resistant Staphylococcus aureus (MRSA) as well as allergen sensitization (P < 0.05). After adjusting for age and gender, male gender (odds ratio (OR) 5.962; 95% confidence interval (CI) 2.136 - 16.644, P = 0.001), positive MRSA (OR, 10.625; 95% CI, 2.823 - 39.982, P < 0.001) and allergen (OR, 4.622; 95% CI, 1.573 - 13.578, P = 0.005) test results were strongly related to the presence of hypoalbuminemia. Conclusions Hypoalbuminemia in AD children with SCORAD score ≥ 40 is associated with increased complications.