Possibilities of allergic reaction therapy in pediatric practice

Abstract

Introduction. Allergic diseases are a global medical and social problem due to the adverse effect on the physical, psychological and social state of a person. The basic principle of pharmacological therapy of acute allergic diseases is acute urticaria, angioedema (Quincke) – control/elimination of syndromic complexes.Aim. To evaluate the clinical efficacy of the antihistamine dimetindene in the treatment of acute allergic reactions in children.Materials and methods. We analyzed 36 patients aged 3 to 17 years with diagnoses of acute urticaria and acute urticaria with angioedema in a state of moderate severity. Patients felt a violation of the general condition – malaise (88.89%), chills/fever (5.56% and 8.34%, respectively), joint pain (2.78%). All patients underwent general clinical, laboratory and instrumental examination with subsequent analysis of the data obtained. To assess the response to treatment, UAS 7, the CU-Q2oL quality of life questionnaire were used.Results and discussion. The article discusses the main aspects of acute urticaria and angioedema, as the most common nosological forms in patients with atopy. The features of antihistamine therapy and its influence on the stages of the inflammation process are analyzed. The level of eosinophilia in the general blood test (median and interquartile range) was 6.5% (1.3%; 19.1%). An increase in total IgE was recorded in 80.56% of patients. The burden of allergic history was revealed in 86.12% of patients. By the end of the 1st day of treatment, symptoms were absent in every tenth patient (χ2 = 1.2461, p = 0.0865), remained in everyfifth child (χ2 = 53.6152, p = 0.0057) and significantly decreased in 2/3 children under study (χ2 = 59.6281, p = 0.0062). By the end of the 3rd day of therapy with dimetindene in the complex of treatment of acute urticaria and angioedema, a statistically significant improvement in clinical dynamics was recorded (χ2 = 102.1364, p = 0.0041) in the combined assessment of symptoms in 4/5 of the subjects and a decrease in discomfort associated with sleep in the overwhelming majority of the subjects (χ2 =51.4627, p = 0.0036).Conclusion. As a result of our own research on the use of dimetindene in patients with acute allergic reactions, it was shown that dimethindene has characteristics that meet the requirements for the exposure of the therapeutic effect, the level of effectiveness and the safety profile.