Abstract
Allergic disease is a serious problem in practical healthcare. Over the last 40 years there has been exponential growth in the prevalence. According to the world health organization information, allergic diseases are at the 2nd place in prevalence the children, behind the viral infections. Their frequency and severity are increasing. In this regard, the relevance of timely and skilled diagnostic allergopathology is most important. In this study the current state of the question of allergy diagnostics is considered, the international experience is summarized and the approach to the allergy diagnosis based on use of step-by-step identification of a causal and significant factor of allergic reactions is offered. On the basis of the analysis of relevance and the importance for patients of one or the other allergens (taking into account a source of allergens and age of patients) use of a step-by-step allergy diagnostics algorithm is offered. The first step is definition of clinical implications of an allergy. It means direct contact of the phisition with the patient, clarification of its complaints, clinical symptoms, medical history disease. The second step is the confirmation of IgE-dependent mechanism. It involves the using of screening tests that are selected depending on the clinical symptoms and seasonality manifestations (the screening module). The third step is to identify the source of the allergens that are most meaningful for the patient with using test panels (modules). The panels include the most common and clinically relevant triggers of allergic reactions. The fourth step is the search for an individual significant allergens, which were not included in the diagnostic modules. On the fifth step, we plan to conduct component-divided diagnostics and detect the antibodies to unique components of significant allergens. The developed diagnostics algorithm, corresponds to needs of both the adult, and children’s population and provides the personalized approach to the patients.
Highlights
In this study the current state of the question of allergy diagnostics is considered, the international experience is summarized and the approach to the allergy diagnosis based on use of step-by-step identification of a causal and significant factor of allergic reactions is offered
The second step is the confirmation of IgE-dependent mechanism
It involves the using of screening tests that are selected depending on the clinical symptoms and seasonality manifestations
Summary
По данным Всемирной организации здравоохранения, в настоящее время одной из наиболее значимых проблем, особенно в педиатрии, являются аллергические заболевания: у детей данная патология по распространенности занимает второе место. В настоящей работе рассматривается современное состояние вопроса диагностики аллергических заболеваний, обобщен мировой опыт и предложен подход к диагностике аллергии, опирающийся на использование пошагового выявления причинно-значимого фактора аллергических реакций. На основании анализа актуальности и значимости тех или иных аллергенов для пациентов (с учетом источника аллергенов и возраста пациентов) предложен пошаговый алгоритм диагностики аллергии. Третий шаг ― выявление источника аллергенов, наиболее значимого для пациента, с использованием тестовых панелей, объединяющих наиболее распространенные и клинически значимые триггеры аллергических реакций. Во всем мире отмечается высокая распространенность аллергических заболеваний, увеличивается число случаев тяжелых аллергических реакций; данная патология затрагивает пациентов любой возрастной категории и со временем только прогрессирует; значительно ухудшается качество жизни самого пациента и его семьи [1, 2].
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