NASAL METACHROMATIC CELLS IN INFANCY IN RELATION TO THE APPEARANCE OFATOPIC DISEASE DURING THE FIRST 6 YEARS OF LIFE

The relationship between the appearance of nasal metachromatic cells ( basophils and mast cells) during the first 18 months of life and the d evelopment of respiratory and other allergic diseases up to 6 years of age was studied prospectively in 67 children. Follow-up was done at 3 , 6, 9, and 18 months and 6 years. Of the 31 children who had detectab le metachromatic cells in the nasal mucosa during infancy, 18 had atop ic manifestations at 6 years (58%), two were probably atopic (6%), and 11 (36%) were nonatopic. The corresponding numbers for the 33 childre n without detectable metachromatic cells during infancy were 10 atopic (30%), two probably atopic (6%), and 21 nonatopic (64%) at 6 years (P <0.05). Children having detectable nasal metachromatic cells at every examination were more often allergic than children with no detectable cells at any time during the 6-year follow-up period (P<0.05). In cont rast, nasal metachromatic cells were equally commonly demonstrated at 6 years in children with and without current atopic manifestations. We conclude that metachromatic cells appear at an earlier age in the nas al mucosa of atopic than nonatopic infants. The observation further su pports the existence of a primary immunologic abnormality in atopic pa tients as related to allergic inflammatory responses The diagnostic ef ficacy of this marker was too low, however, to be clinically useful as a predictor of allergy.