IMMUNOLOGICAL STUDY OF MELKERSSON-ROSENTHAL SYNDROME - LACK OF RESPONSE TO FOOD ADDITIVE CHALLENGE

A study was made of six patients with Melkersson-Rosenthal syndrome (M RS) to establish the aetiological role of foodstuffs and/or additives and the possible associated immunological alterations. In all cases Me lkersson-Rosenthal syndrome (MRS) was diagnosed both clinically and hi stologically, excluding other causes of orofacial granulomatosis (OFG) . A detailed study of possible triggering factors was performed in all patients. Blood analysis, x-rays and cultures, were always within nor mal limits, with the exception of the finding of circulating immune co mplexes (CICs) in three patients with facial palsy associated, and C-r eactive protein positivity in two patients who presented persistent la bial oedema. All patients were subjected to skin-prick tests with comm on inhalant allergens and with foods when sensitization to foods were suspected, and patch tests with European Standard Series and pastry co mponents, organic dyes, perfumes and fragrances series. The results we re negative in all cases. When asymptomatic, the patients were subject ed to a double-blind oral challenge, under placebo control, with addit ives (monosodium glutamate, tartrazine, sulfites, erythrosine, paraoxy benzoate, sodium benzoate, lactose, aspirin, and annate), which was ag ain negative. In no case did the patients refer the appearance of outb reaks with exposure to foods or contactants, and the course of the dis ease was unaffected by exclusion diets and the elimination of contacta nts. To conclude, we observed no sensitization to foods, additives or contactants in our patients. Likewise, there were no antecedents of at opy or hereditary predisposition related to the aetiopathogeny of MRS. The significance of the CIC encountered only in patients with facial paralysis remains to be established, due to the limited number of pati ents studied.