Metachromatic cells and eosinophils in atopic children : A prospective study

• Metachromatic cells and eosinophil leukocytes were studied prospectively in 64 newborns with and without a family history of atopic disease (FH). Cellfindings in nasal mucosa and peripheral blood were related to development of atopic symptoms up to 18 months of age. For this purpose, a gentle scraping method suitable for infants was developed. Nasal metachromatic cells were more prevalent in atopic than in non-atopic infants. The cells were found in infants with respiratory allergy as well as in infants with eczema. Non-atopic infants with metachromatic cells all had FH. The cells were detected prior to or at the time of diagnosis. Thus, metachromatic cells are associated with atopic propensity as defined by development of atopic disease and/or a FH. Infants with respiratory allergy had more often acute otitis media compared to infants with eczema and non-atopic infants. Appearance of nasal metachromatic cells were associated with increased middle ear morbidity in atopic and non-atopic infants and high scores of cells correlated with high numbers of otitis media. Infants with respiratoryallergy may have otitis media as a result of the allergic condition. Blood eosinophils were studied in a total of 154 infants and were found to decrease with age. Blood eosinophilia at 3 months preceded atopic development but was not associated with FH. Nasal eosinophilia was a common finding in atopic and non-atopic infants. In conclusion, appearance of nasal metachromatic cells and blood eosinophilia are associated with atopic disease and may have roles as predictors of atopic disease.

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