мЬ ПЕДИАТРИЯ
263
Devorova M. B., Makhkamova G. T.
Allergic diseases are a global public health
problem. Allergic rhinitis is the most common in both
pediatric and adult populations. According to WHO
data, more than 40% of the population in developed
countries have signs of allergic readiness. Currently, the
incidence of allergic rhinitis in the general population is
10-20% and these figures tend to further increase this
disease [4,8]. This disease limits the life activity of
children, reduces their social and physical activity, as
well as their quality of life and general well-being in
general [6]. According to the results of epidemiological
studies, allergic rhinitis affects about 20% of the
population of all age groups. According to various data,
54-75% of patients with allergic diseases have a
hereditary predisposition. The relationship between the
course of AR and the functional state of the autonomic
nervous system (ANS), peculiarities of vegetative
changes in different forms and severity of the disease
course, their dynamics under the influence of various
methods
of
treatment,
targeted
correction,
morphological changes in the nasal cavity tissues taking
into account the initial vegetative tone (IVT) of the
organism are not properly reflected [2,3,5]. Thus, the
analysis of modern literature has shown that the
problem of formation and course of AR in children is
one of the significant aspects of medicine, including
pediatrics and immunology [6]. The occurrence and
course of allergic diseases are significantly influenced
by climate-geographical conditions of the human
environment, ethnic features of the population, lifestyle
and diet, individual reactivity of the organism, i.e. the
disease
has
clearly
delineated
regional
peculiarities/.The data of epidemiological studies show
that the prevalence of allergic diseases has increased 3
times in the last ten years and is now a serious social,
economic and medical problem [9].
Among allergic diseases in children, food
allergy is more often a starter. It can clinically exist in
the form of skin, gastrointestinal and respiratory
symptoms and is detected in 6-8% of children in the first
years of life [10]. The number of patients with food
allergy decreases with age, and it is diagnosed in only
1-2% of adults. At the same time, 60% of children with
food allergy develop respiratory forms of allergy -
allergic rhinitis and conjunctivitis, bronchial asthma [3].
The growing prevalence, diversity and severity of
clinical manifestations of allergies have intensified the
search for ways to prevent the development of allergic
diseases. As a result, many outdated principles have
been revised and new possibilities of allergy prevention
in children have been formulated.
It is now an undisputed fact that allergic diseases
are based on genetic predisposition. However, genotype
changes alone cannot explain the increasing role of
allergies in the world. As observations have shown,
often the influence of the environment determines the
possibility of realization of hereditary information. A lot
of work has been devoted to this very definition of risk
factors for the development of allergies. Thus, the
analysis of modern literature has shown that the
problem of formation and course of AR in children is
one of the most important problems in the world and
course of AR in children is one of the significant aspects
of medicine, including pediatrics and immunology [6].
The occurrence and course of allergic diseases are
significantly influenced by climate-geographical
conditions of the human environment, ethnic features of
the population, lifestyle and nutrition, lifestyle and diet.
The occurrence and course of allergic diseases are
significantly influenced by climate-geographical
conditions of the human environment, ethnic features of
the population, lifestyle and diet, and individual
reactivity of the organism, the disease has clearly
defined regional features.
Purpose:
To determine the identified
allergens and predisposing factors in children with
allergic rhinitis.
Materials and methods:
Objectification
and verification of the diagnosis was achieved by
obligatory confirmation of its clinical and
laboratory
parameters,
i.e.,
characteristic
DISTINCTIVE FEATURES AND PREVALENCE OF ALLERGIC RHINITIS IN CHILDREN
Tashkent Pediatric Medical Institute
Purpose of the study
: to investigate predisposing factors in children with allergic rhinitis
Materials and Methods.
The object of the study was 217 children with AR were divided into two groups. The first group consisted of 92
children with year-round AR (CAR). The second group included 125 children with seasonal AR (SAR). In turn, 3 subgroups were allocated
in each group taking into account the IVT status.
Results.
From the total number of examined only 56 (25,8%) children and their parents gave the name of allergens, at contact with which
the disease started and the course of AR worsened. Of these, 38 cited only one allergen as the causative one, 10 - two, 6 - three, 3 - four, 1
- five or more. Among this population, children of ATS compared to CAR were predominant, 37 (66.1%) and 19 (33.9%), respectively.
Girls (34-60.1%) had better causative allergen disease compared to boys (22-39.9%). 14 (25%) individuals figured out the type of allergen
themselves and in the remaining 42 (75%), the type of allergen was identified by an allergist earlier, prior to the present study.
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ПЕДИАТРИЯ
complaints and allergic anamnesis, including the
presence of the influence of allergy risk factors,
clinical symptoms, characteristic changes in the
overall analysis allergy risk factors, clinical
symptoms, characteristic changes in the general
blood count, skin allergy tests, IgE in serum, nasal
secretion, positive results of treatment with
antihistamines in the past. When it was not possible
to determine the causative allergens, verification of
the diagnosis was based on the assessment of other
abovementioned parameters in the dynamics.
All 217 AR children were divided into two
groups. The first group consisted of 92 children
with year-round AR (CAR). The second group
included 125 children with seasonal AR (SAR). In
turn, 3 subgroups were allocated in each group
taking into account the IVT status. The children of
preschool age attended one of the kindergartens in
the Yunusabad district of Tashkent city. The
children had been
As can be seen from the table, house dust,
pillow feathers, sheep and dog hair, and egg were
the most frequently reported allergens. The same
permanently residing in Tashkent city for at least 5
years.
Results and their discussion:
The list of
allergens and predisposing factors of AR
development was studied on the basis of
complaints of patients and their parents, history of
the disease and life history, scarification allergy
tests. From the total number of examined children
only 56 (25,8%) children and their parents gave the
name of allergens, contact with which started the
disease and worsened the course of AR. Among
this population, children of ATS compared to CAR
were predominant, 37 (66.1%) and 19 (33.9%),
respectively. Girls (3460.1%) causative allergen of
the disease better compared to boys (22-39.9%). 14
(25%) individuals figured out the type of allergen
themselves, while in the remaining 42 (75%) the
type of allergen was identified by an allergist
physician earlier, prior to the present study. The list
of causative allergens reported by the patients and
their parents are given in Table 1.
Table 1
allergens often appeared in polysensitisation. Girls
were more likely to point to the odour of flowers,
washing powder, sheep's wool and dog,
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Type of allergen
Identified cases of allergy,in absolute numbers
Girls (n=124)
Boys (n=93)
Total (n=217)
house dust
73
66
139
pillow feather
66
47
113
woollen clothes
47
31
78
washing powder
47
10
57
Cold
12
16
28
perfumes
49
12
61
conditioned air
7
7
14
tobacco odour
13
19
32
flower odour
68
44
112
Wormwood
42
37
79
Swan
41
33
74
sheep hair
29
44
73
cat hair
18
14
32
dog hair
31
41
72
cattle hair
11
42
53
Fish
19
21
40
E
gg
56
49
105
citrus fruits
17
19
36
red beetroot
13
11
33
walnuts
36
41
77
sensitisation to:
42
36
78
one allergen-
82
57
139
List of allergens according to a survey of children with allergic rhinitis and their parents,
in per cent
265
and polypragmasia was more frequently detected
in them, boys - citrus fruits, flower odour, walnut,
sheep and dog hair. A total of 158 (72.8%) AR
children and their parents indicated the presence of
allergic diseases in relatives. In relation to the
examined child proband, allergic diseases diseases
were manifested in 38 (24.1%), ascending and 30
(19%) in lateral directions of the of the
genealogical tree, and 90 (56.9%) revealed their
combination in different variations. In relatives, 28
(17.7%) were found to have food allergy, 20
(12.7%)-allergic rhinitis, 19 (12%) drug allergy, 14
(8.9%) bronchial asthma, 14 (8.9%) allergic
dermatitis, 6 (3.7%) urticaria and 57(36.1%)
combination of them. All 217 patients with AR
were skin scarification test was performed. Its
results varied wide ranges depending on depending
on the form, severity of AR, the number of
allergens detected. Types of detected reactions. As
can be seen from the table, there is a correlation
between the degree of reaction manifestation and
all the analyzed parameters. The scarification test
manifestations were more pronounced in the
following cases at: -CAP compared to CAR;
-heavy, then medium-heavy and the least light
course of the disease regardless of the form of AR
and type of IVT regardless of the form of AR and
type of IVT;
-vagotony, then normotony, and sympathicotony
regardless of the form of AR;
Based on the analysis of the frequency of detection
of various allergens during scarification test, the
following was revealed:
-
the species composition of allergens differed in
CAR and ATS;
-
epidermal, household, and food allergens were
detected mainly in ATS;
-
the causative factor of ATS was mainly pollen
allergens, namely - cotton, pyramidal poplar,
willow, walnut, wormwood;
-
in ATS children, a more pronounced reaction
was noted in the presence of organism
sensitiveness to sheep and dog hair and house dust;
-
in AR children more pronounced reaction was
noted in the presence of sensitiveness to cotton,
pyramidal poplar, willow, walnut, wormwood.
Conclusions
Thus, different types of allergens were detected in
AR children with the help of scarification test,
which had differences in different forms of the
disease. The degree of manifestation of allergic
reactions differed depending on the form, clinical
course of AR and IVT organism course of AR and
the organism's IVT. All these data require attention
and are important for diagnosis, differential
diagnosis, assessment of the clinical course and
effectiveness of treatment of this disease.
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