APPARENT LIFE-THREATENING EVENTS PRECIPIT ATED BY BATHING IN INFANTS - A PEDIATRIC FORM OF AQUAGENIC URTICARIA

Background. - Apparent life-threatening events in infants are a diffic ult and frequent problem in pediatric practice. The prognosis is uncer tain because of risk of sudden infant death syndrome. Case reports. - Eight infants aged 2 to 15 months were admitted during a period of 6 y ears; they suffered from similar maladies in the bath: on immersion, t hey became pale, hypotonic, still and unreactive; recovery took a few seconds after withdrawal from the bath and stimulation. Two diagnoses were initially considered: seizure or gastroesophageal reflux bur this was doubtful. The hypothesis of an equivalent of aquagenic urticaria was then considered; as for patients with this disease, each infant's family contained members suffering from dermographism, maladies or eru ption after exposure to water or sun. All six infants had dermographis m We found an increase in blood histamine levels after a trial bath in the two infants tested. The evolution of these ''aquagenic maladies'' was favourable after a few weeks without baths. After a 2-7 year foll ow-up, three out of seven infants continue to suffer from troubles ass ociated with sun or water. Conclusion. - ''Aquagenic maladies'' could be a pediatric form of the aquagenic urticaria.