Сучасні погляди на етіопатогенетичні механізми гострої кропив’янки в дітей

Abstract

The purpose - to analyze modern approaches to understanding the mechanisms of occurrence and etiological factors of acute urticaria in children. Acute urticaria remains a common pathology in the structure of emergency conditions. That is why there is a need for a unified approach to understanding the mechanisms of its occurrence, as well as the management of such patients. The results of modern research on the interpretation of the causes of the appearance of acute urticaria in childhood are given. Identification of an etiological factor is not always successful; triggers or risk factors can be confirmed only in 21-55% of cases. However, this fact does not diminish the interest in the problem. Taking into account the fact that the mechanisms of urticaria can be immune or non-immune, their clinical features are given, detailing possible etiological factors. Considerable attention is paid to the mechanisms of mast cell degranulation, which can be caused by immune effects (IgE, activation of the complement system, immune complexes); direct influence of certain chemical or physical factors on fat cells without the development of a hypersensitivity reaction (histamine release); or instability of mast cell membranes (congenital defects). The authors highlight good reasons among medicines and food products that have a pronounced histamine-releasing ability, which helps the practicing doctor in understanding the mechanisms of urticaria. Given the children’s age, many researchers are interested in the role of infectious agents in the pathogenesis of urticaria. It is generally known about the high prevalence of acute infectious pathology in children, as well as the higher infectious index especially in children of the first years of life. According to the results of numerous publications, an obvious connection with viral and bacterial infections has been established in more than 80% of children with acute urticaria. It is often difficult for the clinician that acute viral infections can cause rashes on the skin, which must be differentiated from urticaria. It is appropriate to recall that clinically, urticaria can be manifested by a large number of diseases: somatic, oncological, autoimmune, which requires careful differentiation. No conflict of interests was declared by the authors.