Volume 71 • Number 4 • Desember 2022
Quality of life, nutritive status and physical development of atopic dermatitis children
D. A. Rakcheeva, N. B. Migacheva, O. V. Sazonova, M. S. Nurdina
Introduction. Atopic dermatitis in children is an important medical and socio-economic problem of pediatrics and clinical allergology due to its wide prevalence in the pediatric population, variety and severity of clinical manifestation. In recent years, the attention of scientists has been attracted by the issues of impaired quality of life, changes in the nutritional status and physical development of such patients, associated both with the influence of the disease and the negative impact of many restrictive measures and elimination diets.
The aim of the review is to analyze and systematize the currently available scientific data on the quality of life, nutritive status and physical development of atopic dermatitis children and the most important factors that may influence them.
Sensitization peculiarities for children with allergic rhinitis living in Magnitogorsk and Beloretsk cities
E. V. Andronova, T. S. Lepeshkova
Basis. Allergic rhinitis is a common chronic disease. The significant increase in incidence among children alarms doctors and parents. We have only isolated epidemiological data on the frequency of occurrence, prevalence and morbidity among children of early and preschool age. The allergic rhinitis incidence depends on the patients’ age, residence, atopic heredity, and other factors. Local studies on the spectrum of sensitization have great practical value. The data gathered from region of residence helps to identify and eliminate clinically significant triggers at an early stage and to prevent the development of comorbid diseases and co-conditions.
The aim is to analyze the sensitization profile of 2–4 years-old children with allergic rhinitis living in two neighboring territories: Magnitogorsk (Chelyabinsk region, Russia) and Beloretsk (Republic of Bashkortostan, Russia).
Methods and research material We examined 107 children from two to four years old with diagnosed allergic rhinitis. All patients were divided into two groups according residence: 1st group — 71 kids (average age 3,2 ± 0,7 years) from Magnitogorsk (Chelyabinsk region, Russia), 2nd group — 36 kids (average age 3,1 ± 0,8 years) from Beloretsk (Republic of Bashkortostan, Russia). The children were tested for total IgE and eosinophilic cationic protein, specific IgE (sIgE) to house dust mites, allergens of trees, weeds and grasses, epidermal allergens (ImmunoСap, Phadia). The rate of sensitization to sIgE was estimated in kU/l. The scale of antibodies level is from undetectable (less than 0,35) to extremely high (more than 100).
Results. The received data shows that children in both groups have high sensitization level to cat and dog allergens, as well as to birch pollen. In addition, patients from Beloretsk have significally more confirmed cases of sensitization to house dust mites (genus Dermatophagoides) than ones from Magnitogorsk (р < 0,01).
Summary. To get more accurate idea of sensitization spectrum and level among regions of Russia, it is necessary to examine local areas and regions of residence. Local detailed information will help to design an algorithm of treatment aimed to prevent severe forms of allergic diseases in a particular region or territory.
Allergic rhinitis caused by plant pollen in adolescents
G. M. Nurtdinova, E. S. Galimova, S. G. Khamidullina, V. K. Muslimova, A. I. Gareeva, D. O. Galimov
Background. Allergic rhinitis is caused by grass pollen is a common problem in the world. The symptoms of this disease can varied on the age of the patient.
Aim: to identify the etiology and analyze the clinic of allergic rhinitis in adolescents.
Methods. An allergic examination was carried out in 96 patients with allergic rhinitis signs who were treated at MEGI MC, which included the study of an allergic history and setting of scarification tests, determination of IgE, comparison of clinical manifestations and detection of sensitization to pollen of various plants in adolescents with allergic rhinitis.
Results. The prevailing share of girls was 65.4%. The etiological factors were tree pollen in 28.6% of cases (in 27 patients), weeds — 12.4% (12 people), meadow grasses — 10.6% (10 people), meadow and weeds — 8.3 % (8 people), a combination of trees, meadow and weeds — 6.4% (6 people) and trees and meadow grasses — 4.7% (4 people).
Conclusion. Typical clinical manifestations consist of light and middle rhinitis — 71 people (94%), conjunctivitis — 45 people (58.8%), rhinosinusitis — 22 people (28.6%), bronchial asthma — 10 people (10.4%).
Model for predicting the risk of severe bronchial asthma in children
O. E. Semernik, A. A. Lebedenko, E. B. Tyurina, M. V. Dudareva
Objective: to develop a model for predicting the severe course of bronchial asthma (BA) in children.
Materials and methods: a comprehensive examination was conducted of 213 children aged 3 to 12 years suffering from atopic asthma (mild course was observed in 85.0%, moderate — in 10.3%, severe — 4.7%). A statistical analysis of clinical and laboratory parameters was performed using the logistic regression method, which allowed us to identify a number of factors that increase the probability of developing a more severe course of BA in children.
Results. A mathematical model for predicting the risk of severe bronchial asthma in children has been developed, including such factors as the child’s age, the degree of respiratory failure, the value of the peak expiratory rate, the duration of the disease, and the presence of an association of exacerbations of the disease with changes in the weather and physical activity. A computer program has also been developed that allows you to automatically calculate the amount of risk after entering the child’s data.
Conclusion. The use of this model makes it possible to predict the further course of BA with a high degree of confidence, and, consequently, to correct the basic therapy in time to prevent the development of complications in a sick child.
Clinical and immunological features of the atopic dermatitis in children
E. B. Belan, M. A. Chueva, T. L. Sadchicova
Background: “atopic march” (AM) is the natural history of allergy mostly in children.
The aim: to describe the production of biomarkers of allergic inflammation in dependence on the duration of AD.
Patients and methods. 94 children suffered from atopic dermatitis (AD) have been included to the study. The severity of the disease has been estimated, serum level of total IgE, IL-4, interferon gamma and sIL-2R have been estimated.
Results. Coexistence of AR and AD was diagnosed in 32/94 (34.0%) patients. Less severity of AD (SCORAD 32.3 ± 9.17 score vs 22.2 ± 2.29 score, p < 0.05), but higher serum level of total IgE (Ме 123 [Q1-Q3 67–156] IU/ml vs Ме 53 [Q1-Q3 5–108] IU/ml, р < 0.001), IL-4 (Ме 12.0 [Q1-Q3 8.7–16.1] pg/ml vs Me 6.0 [Q1-Q3 2.2–12.1] pg/ml, р = 0.0399) and sIL-2R (Ме 2.1 [Q1-Q3 0–20] IU/ml vs Me 0 [Q1-Q3 0–12.9] IU/ml, р = 0.3365) are detected in comorbid patients. Eposides of wheezing are associated with additional risk of AD (OR 2.3 [95% CI 1, 18–4,54]).
Discussion. The development of AR in children with AD is considered as progression of natural history of allergy. In our study it was associated with higher level of IgE, IL-4 and sIL-2R. At the same time the comorbid patients had less severity of AD.
Conclusion. The coexistence of AD and AR in 3-year-old children is associated with less severity of skin symptoms but higher frequency of sensitization to inhalant allergens than in AD. AM is accompanied by higher production of Th2-dependent parameters and markers of early activation of T-cells. The probability of the AM is higher in 2 times if there were wheezing episodes in the anamnesis.