Manifestations Of Food Allergy Research Articles

Metabolomics identifies phenotypic biomarkers of amino acid metabolism in milk allergy and sensitized tolerance

BackgroundA substantial proportion of sensitized individuals tolerate suspected foods without developing allergic symptoms; this phenomenon is known as sensitized tolerance. The immunogenic and metabolic features underlying the sensitized-tolerant phenotype remain largely unknown. ObjectiveIn this study, we aimed to uncover the metabolic signatures associated with clinical milk allergy and sensitized tolerance using metabolomics. MethodsWe characterized the serum metabolic and immunological profiles of children with clinical IgE-mediated milk allergy (MA; n = 30) or milk-sensitized tolerance (MST; n = 20) and healthy controls (n = 21). A comparative analysis was performed to identify dysregulated pathways associated with the clinical manifestations of food allergy. We also analyzed specific biomarkers indicative of different sensitization phenotypes in children with MA. The candidate metabolites were validated in an independent quantification cohort (n = 41). ResultsMetabolomic profiling confirmed the presence of a distinct metabolic signature that discriminated children with MA from those with MST. Amino acid metabolites generated via arginine, proline, and glutathione metabolism were uniquely altered in children with sensitized tolerance. Arginine depletion and metabolism through the polyamine pathway to fuel glutamate synthesis were closely associated with the suppression of clinical symptoms in the presence of allergen-specific IgE. In children with MA, the polysensitized state was characterized by disturbances in tryptophan metabolism. ConclusionsBy combining untargeted metabolomics with targeted validation in an independent quantification cohort, we identified candidate metabolites as phenotypic and diagnostic biomarkers of food allergy. Our results provide insights into the pathological mechanisms underlying childhood allergy and suggest potential therapeutic targets.

Modern Possibilities for Predicting Systemic Manifestations of Food Allergy Based on the Results of a Prospective Cohort Study

Modern Possibilities for Predicting Systemic Manifestations of Food Allergy Based on the Results of a Prospective Cohort Study

A personalized approach to the management of breastfed infants with functional gastrointestinal disorders and cow’s milk allergy. The role of nutritional recommendations for a nursing mother

Introduction. Functional gastrointestinal disorders (FGID) in infants are a complex of symptoms from the gastrointestinal tract that cannot be explained by structural or biochemical disorders. To alleviate the symptoms of functional disorders, a set of measures is required, first of all, psychological support for the mother and, of course, rational feeding, which includes maintaining breastfeeding, optimizing the nutrition of the nursing mother. Despite the abundance of professional information on this issue, previous studies demonstrate a low level of women’s awareness of nutrition during breastfeeding. The aim of the work is to determine the effectiveness of recommendations on nursing mother’s nutrition in the complex treatment of breastfed children with FGID and allergy to cow’s milk proteins.
 Materials and methods. Seventy five mother–child pairs were included in the study. 1–4 months infants exclusively breastfed during the study were divided into two groups: 1 — FGID infants (n = 51) and 2 — infants with suspected cow’s milk allergy (CMA) n = 24. In addition to the comprehensive treatment of the child, mothers of both groups were given recommendations on the nursing woman’s nutrition. Mothers of children from group 2 were assigned a diagnostic dairy-free diet for a period of 1 month. 
 Results. On the 2nd visit, when analyzing the symptoms of the FGID in group 1, the number of children with symptoms of regurgitation of more than 2 episodes per day decreased by 28% (p < 0.001), crying for more than 3 hours per day — by 52% (p < 0.001). Children of group 2 with a clear positive effect from the diagnostic dairy-free diet therapy of the mother (n = 20) were diagnosed with Allergic and alimentary gastroenteritis and colitis (K52.2 — 10th revision of ICD-10), the continuation of the dairy-free diet for the mother and the supervision of an allergist were prescribed. The survey of women showed that all nursing women were interested in nutrition issues during lactation, 92% of the surveyed mothers searched for this information on the Internet. At the same time, only 12% of women considered this information to be sufficient. Evaluating the presented materials on nutrition, the overwhelming majority of respondents replied that they helped them to adjust their diet and expand nutrition, as well as to maintain breastfeeding.
 Conclusion. Thus, an integrated approach in the management of FGID infants and gastrointestinal manifestations of food allergies, including the use of nutrition recommendations developed in the National Medical Research Center of Children’s Health for nursing women, allows achieving a positive effect on the side of symptoms both in FGID and CMA patients, and also contributes to the improvement of the psycho-emotional state of a woman and prolonged breastfeeding.

A clinical case of secondary eosinophilia in a child

A couple of decades ago, the diagnostic search for the cause of blood eosinophilia concerned, mainly, the three major allergic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis), or parasitic invasion. In recent years, more and more complex clinical syndromes, from reactive (secondary) eosinophilia to eosinophilic leukemia are increasingly considered by the doctors of different specialties. The aim of our work was to present a clinical case of secondary eosinophilia in a child with minimal clinical manifestations. Highlights: Sometimes blood eosinophilia in a patient is an “unexpected finding” for a physician, especially if the complaints are scanty, nonspecific, and objective examination does not reveal any significant health abnormalities. In the presented case, secondary (reactive) peripheral blood eosinophilia was diagnosed due to intestinal damage induced by food allergens. This clinical case is of practical interest to physicians, presenting a diagnostic search for the cause of blood eosinophilia, which eventually proved to be a mixed IgE/ non-IgE mediated food allergy manifesting as allergic enterocolitis. The IgE-mediated mechanism of food allergy is evidenced by a high level of IgE and its decrease with administered elimination diet; delayed-type response and low severity of clinical manifestations of food allergy, as well as blood eosinophilia suggest a non-IgE mediated food allergy. In this particular case, the severity of laboratory changes (blood eosinophilia, a significant increase in the levels of specific IgE) was associated with scarce intestinal symptoms. An opposite situation is observed, especially, in young children where the disease manifests with a pronounced clinical pattern of enterocolitis in the absence of laboratory changes.

Knowledge and Awareness About Food Allergy Among Mothers With Allergic Children in the Aseer Region, Saudi Arabia.

Introduction Food allergies have become a significant health concern worldwide, affecting individuals of all age groups. It is particularly challenging for parents who have children diagnosed with food allergies, as they bear the responsibility of managing their child's condition and ensuring their safety. This study aimed to assess the knowledge and awareness about food allergies among mothers with allergic children in the Aseer region, Saudi Arabia. Methodology A cross-sectional study design was employed, and data were collected through a structured questionnaire administered to 400 mothers. The participants were selected through convenience sampling. Descriptive statistics, including frequencies and percentages, were used to summarize the demographic characteristics, knowledge and awareness levels, prevalence of allergenic foods, manifestations of food allergies, and factors influencing food allergies. Chi-squared tests were conducted to assess associations between variables. Results The study revealed a balanced representation across different age groups among the surveyed mothers, with the highest proportion falling in the 31-40 years range. A significant proportion of mothers had a university education, indicating a relatively higher level of education among the participants. The majority of mothers were employed in governmental positions, followed by housewives and those working in the private sector. Regarding knowledge and awareness, a substantial percentage of mothers correctly identified key aspects of food allergies. However, knowledge gaps were observed, particularly in understanding the hereditary nature. The prevalence of allergenic foods varied, with seafood (fish, shrimp, and tuna) emerging as the most commonly reported allergenic foods, followed by eggs, milk, wheat, chocolate, fruits, nuts, and other food types. Manifestations associated with food allergies were reported, including skin, respiratory, eye, nasal, gastrointestinal, and other symptoms.The associations between different feeding methods and the occurrence of medically diagnosed food allergies were found to be non-significant. However, having other children with food allergies showed a highly significant association with the occurrence of food allergies in the current child. The age of introducing solid food did not demonstrate a significant association with the occurrence of food allergies. Conclusion This study provides insights into the knowledge and awareness about food allergies among mothers with allergic children in the Aseer region, Saudi Arabia. While mothers demonstrated a reasonable understanding of food allergies, knowledge gaps were identified, particularly regarding the hereditary nature. The prevalence of allergenic foods aligns with previous studies, although variations across populations should be considered. The manifestations reported by the participants corroborate known allergic reactions, necessitating further analysis.

Comorbid food allergy in patients with congenital epidermolysis bullosa

Introduction. Inherited epidermolysis bullosa belongs to the group of severe rare hereditary mechanobullous diseases. Often, the skin pathological process is difficult to treat, which leads to a decrease in the quality of life of such patients. The mechanism of development of transcutaneous sensitization in this category of patients is not excluded. This issue remains a very relevant area for study, given the characteristic nutritional deficiency and the difficulties that arise in the formation of the diet.The aim: to assess the frequency of occurrence and characteristics of food sensitization in children with epidermolysis bullosa.Materials and methods: the group included 164 children with epidermolysis bullosa (45 with rapid detection and 119 with dystrophic). For all patients, an assessment of the risk of an allergic history, determination of the total level of IgE and specific IgE of blood serum to the most significant food allergens (UniCAP system, Thermo Fisher Scientific). Results: food sensitization was detected in 34.1 % of children with epidermolysis bullosa (in 38.7 % of cases with dystrophic and in 24.4 % with a simple form of epidermolysis bullosa). Among the manifestations of food allergy in both groups, skin symptoms were more common. The most common etiological factors were products containing cow’s milk protein, eggs, and cereals. In the group of children with comorbid food allergies and epidermolysis bullosa, high and extremely high levels of total IgE were most common.Conclusion: a high frequency of food sensitization in patients with epidermolysis bullosa, was shown, which is important not only from a scientific, but also from a practical point of view. Given the nutritional deficiency characteristic of this disease, the complexity of nutritional support, the presence of comorbid food allergies should be taken into account when recommending nutrition and selecting therapeutic products for this category of patients.

The results of the use of a combined probiotic (Lactobacillus rhamnosus GG and Bifidobacterium animalis spp. lactis ВB-12) in children with gastrointestinal and skin manifestations of food allergy

At present, there are sufficient data on the influence of the gut microbiome on the development of food allergy and its progression. Changes in gut microbiome composition could positive impact on the course of allergic diseases by means of regulating the ratio of pro- and anti-inflammatory cytokines, as well as immunoglobulin E level. The purpose of the research was to study the effectiveness of combined probiotic in treatment of food allergies in children. Material and methods. The prospective randomized controlled study included 92 children aged from 4 to 5 years with symptoms of food allergy, involving the skin and gastrointestinal tract. The main group (n=46) took two chewable tablet Bifiform Kids (Lactobacillus rhamnosus GG >1x109 CFU, Bifidobacterium animalis spp. lactis BB-12 >1x109 CFU, thiamine mononitrate 0.40 mg, pyridoxine hydrochloride 0.50 mg per tablet) 2 times per day during 21 days. The control group (n=46) did not take the complex. The dynamics of the severity of food allergy skin symptoms was assessed using the SCORAD index, of gastrointestinal manifestations - on a point scale after 21 days and after 4 and 6 months (visits 2, 3 and 4). The concentration of immunoglobulin E, interleukins IL-17 and IL-10 was determined by enzyme immunoassay in blood serum at the baseline, as well as after 21 days and after 6 months (visits 1, 2 and 4) after the study initiation. Results. The SCORAD index among children from the main group decreased from 12.4±2.3 до 7.6±1.8 (р=<0.05) while taking a combined probiotic. It was significantly lower (р=<0.05) compared to the control group (SCORAD index changed from 12.1±2.4 to 12.2±1.9). On the 21st day, a statistically significant decrease in level of pro-inflammatory IL-17 (by 27%) and a statistically significant increase in the concentration of anti-inflammatory IL-10 (by 38.9%) were recorded. In children from the main group, the severity of such gastrointestinal symptoms as pain, rumbling in the abdomen, belching with air, bloating, gas discharge, increased stool and its unformularity, decreased compare to the control group of patients (р=<0.05), in which the intensity of complaints related to gastrointestinal manifestations did not change. In the main group of patients, the most clinical efficacy was noted immediately after the end of the probiotic intake. In the following five months, the intensity of symptoms increased in individual subjects from the main group, but in general, the intensity of complaints remained significantly lower than before probiotic intake (р=<0.05). Children from the main group showed a significant decrease in IgE level from 184±121 kU/l by 43.5% at visit 2 and by 38.0% at visit 4 (p=<0.05), while in children from the control group its level didn't change, amounting to 176±141, 165±121 and 178±132 kU/l, respectively. Conclusion. The results of the study show the effectiveness of the use of a combined probiotic (Lactobacillus rhamnosus GG, Bifidobacterium animalis spp. lactis ВB-12) with vitamins B1 and B6 in children with mild forms of gastrointestinal and skin manifestations of food allergy, both in relation to the severity reduction of the clinical symptoms of the disease (skin manifestations, pain, rumbling in the abdomen, belching with air, bloating, gas discharge, increased stool and its unformularity), and in relation to the dynamics of biochemical parameters - a decrease in the level of IgE.

Charmadala: Virudhaahar Janya Kushtha - A Case Study

In the midst of movement and chaos of life, we forget to pay heed to our health and as a result of which susceptibility to various allergens is increasing day by day. Allergens can be dust, smoke, fumes, pollen and even food. A person can either be allergic to certain allergen right from his birth or can acquire hypersensitivity in later stage of his life. Food allergy is quite common in present era and is affecting the lives of many people. Although there are a number of manifestations of food allergy like nausea, vomiting, diarrhoea, headache etc, most commonly seen are skin manifestations like blisters, itching, redness, burning sensation, oozing, discolouration etc. Acharyas have also mentioned Virudhaahar as one of the most prominent cause of Kushtha. Virudhaahar is any food that causes sensitivity reactions in a person. In contemporary sciences, there are no such permanent cures for hypersensitivity induced skin diseases. But in Ayurveda, through Shodhana and Shamana, these can be treated effectively and occurrence can also be avoided to some extent. This case report is of 38 yrs old male who visited our OPD with itching, oozing, blisters with intense burning sensation in palms and redness and itching in groin areas. The disease was diagnosed here as Charmdala. The treatment protocol opted was Virechan and Shamana. The patient was assessed every 7 days for a month and showed significant relief. This case thus proves that Ayurveda has the potential for curing Virudhaahar janya Kushtha which is often unresponsive to the contemporary treatment protocol.

Многоликая аллергия: гастроинтестинальные проявления пищевой аллергии у детей. Вопросы диагностики и ведения

The manifestations of food allergies are varied. They affect not only the skin, which pediatricians are traditionally accustomed to, but also the gastrointestinal and respiratory tracts. A typical scenario for the development of gastrointestinal manifestations of food allergy in infants fully reproduces that observed in functional and organic lesions of the gastrointestinal tract. Infantile colic may be the first manifestation of an atopic disease. Therefore, the differential diagnosis of gastrointestinal allergy for pediatricians is important. There is both hyper- and underdiagnosis of the gastrointestinal form of allergy. This is primarily due to the fact that the immunopathological mechanism of gastrointestinal allergy is diverse and includes both IgE-mediated and non-IgE-mediated variants. At the same time, the clinical symptoms almost resemble manifestations of the functional pathology of the gastrointestinal tract and there are no elevated IgE levels. The main method of differential diagnosis is only the elimination of the food product and, conversely, the appearance of symptoms after its return (provocation). Therefore, it is necessary that pediatricians have a clear understanding that the basis of diagnosis is not only clinical symptoms, but the response to diet therapy

Gastrointestinal manifestation of food allergy

Gastrointestinal manifestation of food allergy

Gastrointestinal manifestations of food allergy in children: oral allergic syndrome

Oral allergic syndrome is a manifestation of an acute allergic reaction from the mucous membrane of the oropharynx in the form, itching and tingling on the oral mucosa, dysphonia, itching in the auricles, some patients may experience classic manifestations of hay fever in the form of rhinoconjunctival syndrome. Diagnostics of this disease includes collection of allergic anamnesis, allergy examination. The only pathogenetic method of therapy is carrying out specific immunotherapy with causally significant allergens.

FOOD ALLERGY. POSSIBLE WAYS TO INCREASE THE PREVENTION AND TREATMENT EFFICACY

The relevance of the food allergy problem is beyond doubt. In a number of countries of the world, its prevalence has increased by 2 times in recent years. Manifestations of food allergy, in contrast to food intolerance, are immunologically determined diseases. Immune-mediated diseases caused by food, based on the mechanism of development, are divided into IgE-mediated, non-IgE-mediated and mixed, differing from each other both clinically and immunopathogenetically. Essentially any allergic disease can be caused by food allergens. It should be noted that at present there are several theories of the development of allergies. The difference in food allergy endotypes in combination with other factors affecting the development of sensitization and manifestations of allergic reactions causes a wide variability in the phenotypic manifestations of allergopathology. Diagnosis of them provides individualization and increases the efficacy of the food allergies prevention and treatment. Various types of diets have been described. The permission-elimination diet proposed by us combines the advantages of all of them. Even isolated use of it provides a clinical effect in almost 25% of patients with food allergies. Particular attention is paid to the methods of early introduction of food products to create food tolerance. Methods of medical treatment are characterized including the use of allergen-specific immunotherapy and various biological preparations.

СЕМЕЙНЫЙ АЛЛЕРГОАНАМНЕЗ И СРОКИ ПЕРВЫХ ПРОЯВЛЕНИЙ ПИЩЕВОЙ АЛЛЕРГИИ, ПОСТАНОВКИ ДИАГНОЗА, НАЗНАЧЕНИЯ ЛЕЧЕБНОГО ПИТАНИЯ

The analysis of 63 cases history of children with a confirmed diagnosis of food allergy. It been established that a burdened familial history of allergic diseases had 36 children (57%). It was found that in children with a burdened allergoanamnesis, the first manifestations of food allergies occur significantly earlier than in children without risk factors, at 35 and 61 days, respectively (p&lt;0.05)

Роль продуктов прикорма в формировании вкусовых предпочтений и нутритивного статуса детей

Objective. To evaluate the influence of different patterns of complementary feeding on the formation of nutritional behavior and nutritional status in children between 6 and 12 months old. Patients and methods. The study included 86 practically healthy children; the duration of observation was 10.65 ± 3.65 weeks. Children in the study group (n = 46) received only commercially produced complementary foods; children in the comparison group (n = 40) received both commercially produced and homemade foods. In the study group, parents accurately followed the recommendations on the order, timing, and amount of introduction of complementary foods. Tolerance and nutritional behavior were assessed using specially designed questionnaires. The dynamics of nutritional status against the background of complementary feeding were evaluated. Results. Most of the children tolerated the introduced complementary food products, both commercially produced and homemade, and had average parameters of physical development and nutritional status. Skin manifestations of food allergy (19.6% in the study group, 17.5% in the comparison group) to the following commercially produced complementary foods were revealed: dairyfree buckwheat porridge and any milk porridge, cauliflower, pumpkin, zucchini; and to homemade foods: fish, strawberries, pumpkin. Dyspepsia in the form of increased/decreased frequency of defecation was detected in 13 and 22.5% of children in the study group and comparison group, respectively. Uncontrolled introduction of complementary foods in the comparison group (early introduction of fruit or berry puree, milk porridge, cottage cheese) was accompanied by a 3.5-fold increase in the number of children with excess body weight during the observation period. Rapid substitution of one product with another when a child refused to eat the complementary food product did not allow a positive attitude towards new foods to be formed. In the study group, 10 (66.6%) out of 15 children with an initially negative attitude towards complementary foods agreed to eat the previously unpreferable product, in the comparison group – 1 child out of 4 (p &lt; 0.05). Conclusion. The timing and order of introducing complementary foods is essential for children to develop proper eating behavior and optimal food preferences. Key words: food preferences, complementary foods, breastfeeding, eating behavior

MULTIDISCIPLINARY APPROACH TO MANAGEMENT OF PEDIATRIC PATIENTS WITH SKIN SYMPTOMS OF FOOD ALLERGY

The aim: To determine the significance of multidisciplinary approach to management of pediatric patients with skin symptoms of food allergy. Materials and methods: The study included of 36 patients aged 4 to 6 years with skin manifestations of food allergy, of which 18 were randomly included in the study group and had a multidisciplinary approach to treatment and the other 18 patients constituted a comparison group and used a standard therapy regimen. Observation of children was carried out for 3 months. Results: Assessment of the severity of the cutaneous form of food allergy by SCORAD score showed the average degree of disease activity in the groups of the study at the beginning of treatment and significantly better dynamics in patients of the study group (p=0.0055). In 88.9% (n=16) of patients in the study group and 61.1% (n=11) of the control group, the process became mild. Conclusions: The application of a multidisciplinary approach allows the integrated implementation of medical, nutritional, and psychological aspects, which significantly increases the effectiveness of treatment and improves the quality of life of patients and their parents.

Лактазная недостаточность при аллергии к белкам коровьего молока – дифференцированный подход к выбору лечебной смеси

The similarity of clinical symptoms of lactase deficiency and cow’s milk protein allergy (CMPA), as well as a frequent combination of these pathologies in the form of secondary hypolactasia against the background of CMPA often lead to under-diagnosis of CMPA and erroneous prescription of lactose-free and low-lactose formulas to children with food allergies. Children with the combination of CMPA and secondary lactase deficiency require complete elimination of milk protein from their diet and selection of extensively hydrolyzed or amino acid-based formulas in the absence or lack of breastfeeding. At the same time, exclusion of lactose from the child’s diet is not required in the absence of gastrointestinal manifestations of CMPA, and in the presence of secondary lactase deficiency against the background of CMPA, it is required only until gastrointestinal symptoms are relieved. Therefore, when remission of gastrointestinal manifestations of food allergies is achieved, it is recommended to transfer children to extensively hydrolyzed formulas containing lactose, since therapeutic formulas with lactose provide beneficial effects, including on the gut microbiota and fecal metabolome. This article presents a detailed analysis of literature and proposes an algorithm for individual selection of therapeutic formulas for children with CMPA, depending on clinical manifestations. Key words: cow’s milk protein allergy, amino acid-based formulas, extensively hydrolyzed formulas, children, lactase deficiency, infants, nutrition, food allergy

Clinical and anamnestic characteristics of children with gastrointestinal food alergy

Summary. The prevalence of food allergy is increasing, especially among children. The clinical manifestations of food allergy are different, they depend on the mechanisms of pathogenesis. There is a need to improve diagnostic criteria and early diagnosis of gastrointestinal manifestations of food allergy. Objective. Evaluation of gastrointestinal manifestations in children with food allergies. Materials and methods. Clinical and anamnestic data of 29 children (12 girls, 17 boys) with gastrointestinal manifestations and food allergy were analyzed. Results. Most often, gastrointestinal manifestations of food allergies were found in children aged 4 to 7 years (55.17%, 16/29). Epigastric pain (62.07%, 18/29), meteorism (24.14%, 7/29), undecorated stool with undigested food particles and mucus (27.59%, 8/29%) were most common among children with food allergies. The onset of gastrointestinal intolerance by the age of 6 months was in 44.8% (13/29) of children, 76.9% (10/13) of whom were exclusively breastfed. The first gastrointestinal manifestations after the introduction of supplementary feeding were in 20.69% (6/29); 10.34% (3/29) of patients had gastrointestinal complaints from 3 years of age, and 6.9% (2/29) of patients from 7 years of age. Gastrointestinal disorders as the first manifestation of allergic "march" was observed in 20.69% (6/29%) of patients. IgE-mediated food allergy was found in 72.41% (21/29) of the examined children: immediate gastrointestinal hypersensitivity - 65.51% (19/29); oral allergic syndrome - 6.89% (2/29). Non-IgE-mediated food allergy is represented by protein-induced enterocolitis and proctosigmoiditis in 27.58% (8/29) of children. Conclusions. Clinical symptoms of gastrointestinal manifestations of food allergy in children depend on the immunological mechanisms of its occurrence, it should be taken into during of diagnostic. Gastrointestinal food allergy should be diagnosed in time to prevent the evolution and progression of allergic "march". Therefore, it is necessary to develop and search methods and markers for timely diagnosis of these conditions.

Feeding difficulties in children fed a cows' milk elimination diet.

A cross-sectional study compared feeding difficulties in children aged 2-5 years fed a cows' milk elimination diet due to food allergy with a control group on an unrestricted diet. All data were obtained online. Specific questionnaires evaluated three types of feeding difficulties: avoidant eating, picky eating and feeding problems. The median scores of feeding difficulties in the elimination diet (n 146) and control (n 109) groups were, respectively: picky eating (31 v. 27; P = 0·148), avoidant eating (3 v. 3; P = 0·508) and feeding problems (38 v. 34, P = 0·032). Picky eating was more frequent in the elimination diet (35·4 %) than in the controls (23·3 %; P = 0·042), but no difference was observed for avoidant eating (23·9 % v. 20·4 %, P = 0·508) and feeding problems (32·1 % v. 28·4 %, P = 0·541). Picky eating was associated with lower values of weight-for-age z-scores in both groups. Multivariate analyses identified associations of the three feeding difficulties with previous food refusal and/or inappetence in the elimination diet group. Current constipation and anticipatory gagging were associated with feeding difficulties in both groups. In conclusion, children on an elimination diet presented higher frequency of picky eating and higher scores of feeding problems. Picky eating was associated with lower values of weight-for-age z-scores. Food refusal and/or inappetence as clinical manifestations of food allergy were associated with feeding difficulties at the moment of the survey. Current constipation and anticipatory gagging were associated with picky eating, avoidant eating and feeding problems.

Place of anti-histamine in therapy of itching skin of children

Itching is a frequent condition at a doctor's appointment of any speciality. A quarter of patients complain of itching of various etiology. In real practice, H1-histamine receptor blockers are prescribed for itching in the first place. The article considers a complex of diseases accompanied by itching of the skin.&#x0D; The itching is a reflex. The classification contains a lot of forms:local and systemic; prurigogenic, neuropathic and psychogenic. Itching has no stable pathogenesis and can be provoked by various conditions. The main types of sensory neurons are opiate and 5-HT-receptors. Urticaria and food allergy are associated with irritation of the skin receptors with histamine and other mast cell mediators. In these cases, antihistamines are the drug of choice regardless of the aetiology of urticaria.&#x0D; In atopic dermatitis, the itching has a complex aetiology: transepidermal water loss, chronic inflammation of the skin with the participation of many cells, secondary hyperinervation of the skin with the formation of a pathological activity focus in the brain. This requires a comprehensive approach to therapy. Xerosisis overcome by the use of emollients and rational skincare. The presence of exacerbation makes it necessary to prescribe topical steroids or calcineurin inhibitors for an acute period s. In the case of the addition of psychogenic itching, antiserotonin 5-HT-blockers drugs, hydroxyzine can be considered. H1-receptor blockers do not affect the intensity of skin lesions in dermatitis, but some molecules can reduce the itching.&#x0D; Quifenadine is the antihistamine dug of the second generation. It can be used in the treatment of allergic itching dermatoses. The rapid onset of action allows you to reach the maximum concentration in the tissues within 1 hour, activate monooxidase and neutralise histamine in the tissue. Quifenadine absence a sedative effect and no respiratory depression.Instructions for the use of the medicinal product can increase the dose by 1,5–2 times.It makes the drug useful for the treatment of manifestations of food allergies and urticaria. The dual antihistamine and antiserotonin action allow the successful use of quifenadine in the acute period of atopic dermatitis, especially provoked by contact with an allergen.

Клініко-епідеміологічна характеристика найпоширеніших алергічних захворювань у дітей

Актуальність. Алергічні захворювання (АЗ) (бронхіальна астма (БА), алергічний риніт (АР), атопічний дерматит (АД), харчова алергія (ХА), гостра кропив’янка (ГК), інсектна алергія (ІА)) є життєво небезпечними інвалідизуючими станами та причиною занепокоєння у всьому світі. Мета — визначення поширеності й особливостей сучасного перебігу найбільш поширених АЗ у дітей Київського регіону. Матеріали та методи. Проанкетовано 1011 дітей таких вікових груп: І (1 міс. — 4 роки) — 305, ІІ (6–7 років) — 254, ІІІ (13–14 років) — 254, ІV (15–17 років) — 198. Результати. Отримані досить високі показники поширеності симптомів БА, АР, АД, ХА, ГК та ІА. При цьому виявлені суттєво низькі рівні діагностики даних захворювань, зокрема БА. Незважаючи на значну частоту випадків приступів візингу (більше трьох за минулий рік життя), у дітей всіх вікових категорій вірогідно низька діагностика БА (р = 0), особливо в дітей до 4 років. За отриманими результатами відмічається суттєве зростання частоти проявів ХА у вигляді гострої кропив’янки й ангіонабряку в більш ранньому віці. Відсоток даних проявів у дітей до 4 років вірогідно перевищує рівень показників інших вікових категорій (р &lt; 0,015). Висновки. Рівень діагностики АЗ, зокрема БА, в Україні залишається низьким, особливо в дітей до 4 років.