Allergic rhinitis in preschool children: clinical and allergological characteristics and comorbidity
Abstract
Summary. The problem of allergic rhinitis in children is important in clinical pediatrics, which is associated with a significant increase in the prevalence, early onset and diversity of clinical manifestations of the disease, reminiscent of infectious rhinitis, and therefore causes serious underdiagnosis, untimely and inadequate highrisk therapy. development of complications and evolution into bronchial asthma.
The aim of the study was to study the clinical and allergic features of allergic rhinitis in preschool children, both isolated and combined with asthma and atopic dermatitis at their request to an allergist in the Consultative Diagnostic Clinic (CPC) NDSL "OKHMATDIT".
Materials and methods. Clinical and anamnestic data, objective examination, oto- and rhinoscopy, general clinical examinations, determination of serum immunoglobulin E, skin prick-tests with allergens, consultation with an otolaryngologist were subject to analysis. The article presents modern views on the problem of allergic rhinitis in preschool children. The analysis of clinical and allergic characteristics, in particular, describes the most common clinical symptoms and their severity, family history, laboratory parameters, such as total immunoglobulin E in peripheral blood, skin tests. Based on our own data, the early incidence of allergic rhinitis in preschool children, including the first years of life and its high comorbidity with other allergic diseases, including bronchial asthma, atopic dermatitis, urticaria, etc. has been demonstrated.
According to the results of rotational tests - in 30% of patients polyvalent sensitization was detected. Despite the age of the examined children (feature-reduced skin sensitivity) - the percentage of positive results was sufficient. Family allergy history was burdened in all patients, mostly asthma in one parent. All children had high levels of total serum immunoglobulin E.
Thus, there is an early onset of allergic manifestations and high sensitization of young children to the most common allergens. The issue of early detection of AR is extremely important to study among the preschool population, due to the need for early detection of people prone to asthma, to achieve better control of the disease and prevent severe disease, complications and early disability of children.
Downloads
References
Okhotnikova OM, Hlohush II, Allergic rhinitis and bronchial asthma in preschool children: possibilities of modern therapy of comorbid diseases. Contemporary Pediatrics, 2017;5:73-87. DOI: https://doi.org/10.15574/SP.2017.85.73. [Ukrainian].
Zabolotny DI, Laiko AA, Okhotnikova ОМ, Kosakovsky AL. Allergic rhinitis in children: Monograph / and others. - Kyiv: Logos, 2016. - 216 p.
Umanets T, Matveeva S. Allergic Rhinitis in Children: to Help the Pediatrician. 2021Sep.21;(5.73):137-40. DOI: https://doi.org/10.22141/2224-0551.5.73.2016.78313.
Zhernosek VF Allergic rhinitis in children: a modern understanding of the problem, the possibility of controlling rhinitis of the resistant type. International reviews: clinical practice and health. 2014;1(7):20-22 URL: https://cyberleninka.ru/article/n/allergicheskiy-rinit-u-detey-sovremennoe-ponimanie-problemy-vozmozhnosti-kontrolya-rinita-rezistentnogo-tipa. [Russian].
Okhotnikova OM, Duda LV, Clinical and allergological characteristics of the most common allergic diseases in children. "Child Health".2018;13(4):345-355 DOI: https://doi.org/10.22141/2224-0551.13.4.2018.137017. [Ukrainian].
Methodical recommendations are intended for general practitioners, pediatric and adult allergists, pediatricians [etc.] Shupyka. Kyiv:2019 [Ukrainian].
Order of the Ministry of Health and the Academy of Medical Sciences of Ukraine 02.04.2002 N 127/18: On organizational measures for the introduction of modern technologies for the diagnosis and treatment of allergic diseases. https://zakon.rada.gov.ua/rada/show/v0127282-02 [Ukrainian].
Protocol for providing medical care to children in the specialty "Children's Pulmonology": Order of the Ministry of Health of Ukraine №18 of 13.12.2005. [Electronic resource]. - Access mode: http://www.moz.gov.ua[Ukrainian].
Modern possibilities of allergy diagnostics in children aged 3-5 years. Sharikadze. Coll. Science. work collaborate. NMAPE named after PL Shupyk. 2014;23(2). Access mode: http://nbuv.gov.ua/UJRN/Znpsnmapo_2014_23%282%29__60. [Ukrainian].
Umanets TR. Bronchial asthma and allergic rhinitis: ways to optimize compliance and treatment effectiveness. Asthma and allergies. 2015;1:61—64. [Russian].
Unified protocol for the provision of primary, secondary (specialized) medical care for children with bronchial asthma: order of the Ministry of Health Of Ukraine №868 dated 08.10.2013 [Electronic resource]. Access mode: http://www.moz.gov.ua. . [Ukrainian].
Brozek JL, Bousquet J, Baena-Cagnani C.E. [et al.]. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision. J. Allergy Clin. Immunol. 2010;126:466-76.
Allergic Diseases as a Public Health Problem in Europe. The UCB Institute of Allergy. European Allergy White Paper. Available from: https://www.ucb.com/_up/tuioa_com/images/allergic-tobeornottobe_tcm114-.
EAACI 2014, European Academy of Allergy and Clinical Immunology Congress, Copenhagen, Denmark, Jun 7—11, 2014. — Abstr 748.
Allergic diseases as a problem of worldwide healthcare according to materials of 3rd Ukrainian Allergic Congress. Novosti Meditsiny i Farmatsii. 2011;(387). Available from: http://www.mif-ua.com/archive/ ticle/22745. Accessed: November 18, 2011. [Ukrainian].
Bousquet J, Khaltaev N, Cruz AA. [et al.] Allergic Rhinitis and its impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GALEN and AllerGen. Allergy. 2008;63(Suppl.86):8—160.
Agache I, Akdis C, Akdis M. [et al.]. Global atlas of allergic rhinitis and chronic rhinosinusitis. 2015:422 p.
Global strategy for asthma management and prevention. National institutes of health. National Heart, lung and Blood Institute. Revised 2017. Access mode: http://www.ginasthma.org.
Global strategy for asthma management and prevention. National institutes of health. National Heart, lung and Blood Institute. Revised 2016. [Electronic resource]. URL:http://www.ginasthma.org.
Global Initiative for Asthma. Diagnosis and Management of Asthma in Children 5 Years and Younger. Updated 2015. [Electronic resource]. URL: http://www.ginasthma.org.
European Academy of Allergy and Clinical Immunology (EAACI).Tackling the Allergy Crisis in Europe- Concerted Policy Action Needed: AdvocacyManifesto.Availablefrom:http://www.eaaci.org/images/media/EAACI_Manifesto_brochure_Interactive.pdf. Accessed: April 04, 2016