John W. Gerrard

COW'S MILK ALLERGY: PREVALENCE AND MANIFESTATIONS IN AN UNSELECTED SERIES OF NEWBORNS

1. A consecutive series of 787 babies born at the University Hospital were followed for 12–36 months in order to determine the prevalence of cows milk allergy (CMA).

Serum IgE levels in parents and children

Serum IgE levels have been determined in 80 families. Levels less than 150 μ/ml were considered low, levels of 150 μ/ml or above were considered high. Fifty-one matings were between parents with low levels of IgE; 19% of their offspring had high levels. Twenty-two matings were between parents one of whom had a low level of IgE and one of whom had a high level; approximately half (43%) of their children had high levels. Seven of the matings were between parents with high levels, approximately three-quarters (77%) of their children had high levels. The results are consistent with low IgE levels being determined by the presence of two dominant genes, the absence of one or the other permitting high levels to occur. The ultimate levels of IgE are probably also influenced by age and environmental factors such as exposure to helminth and other antigens.

The syndrome of transient diabetes

A transient diabetic syndrome was first noted in an infant at 1 month of age and persisted for 4 months. The mother was found to have consistently low concentrations of blood glucose even after the oral administration of glucose. It is suggested that the infants blood sugar may have been low in intrauterine life so that there was inadequate stimulation of the islets of the pancreas, and the production of insulin remained deficient even into the postnatal period. Spontaneous recovery may have been the result of maturation of the pancreatic islet tissue.

NEUROPHARMACOLOGICAL EVALUATION OF MOVEMENT DISORDERS THAT ARE ADVERSE REACTIONS TO SPECIFIC FOODS

Three cases are reported of patients who had episodic movement disorders triggered by foods or components of the diet. In the first patient, the movement consisted of shaking the head from side to side that was triggered by milk and a number of other foods. In the second patient, the movement consisted of a repeated shrugging of the shoulders that was triggered by egg and coffee. In the third, the movement consisted of rhythmic contractions of the arms and legs that were triggered by aspartame. The first patient agreed to participate in a study in which she drank 250 ml of skim milk, an amount sufficient to trigger head shaking, after pretreatment with drugs known to alter neurotransmission across beta-adrenergic, dopaminergic, GABAergic or purinergic synapses. At the doses used, propranolol and diazepam had no effect on the milk evoked movement disorder. Levodopa (plus carbidopa) blocked the reaction to milk. Haloperidol, salbutamol and theophylline by themselves triggered a reaction similar to that evoked by milk. These observations suggest that, in susceptible individuals, foods can trigger movement disorders through an action on dopamine and other neurotransmitter pathways in the brain. A videotape of the reactions of the first two patients is available.

X-Linked Mental Retardation: Renpenning Revisited

Nine men with X-linked mental retardation (MR) belonging to the family originally described by Renpenning and his colleagues have been reexamined and restudied. None of these men have the fragile X chromosome, and none have macro-orchidism; their testes range in size from small to average. All but one are severely retarded; one has an IQ of 70, the mean IQ of the remainder is 30 with a range of 18 to 45. They are short in stature, have small or normal-size ears and lower jaws, and a moderate degree of microcephaly, the mean skull circumference being just below two standard deviations from the normal.