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Allergic cough in children: how to recognize it and properly treat it?
Last reviewed: 23.04.2024
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Is the baby unwell again? And after another sleepless night spent near his bed in vain efforts to curb the bouts of painful cough, my mother decides to call a doctor. However, in the clinic they always ask about the temperature. But most mothers will think: nothing, I will say that + 37.5 ° С. Although strange, despite such a strong cough, the temperature of the child is normal, and the throat is not red ...
A good pediatrician knows that dry paroxysmal cough can be a sign of anything, including rhinovirus or adenovirus infection, chlamydia and mycoplasma, measles, pertussis, croup, caught in the trachea of a foreign body and even hypertrophy of the thymus gland. In the end, it may just be an allergic cough in children.
But in reality everything is not easy. The cough has a physiological purpose: to clear the respiratory tract from everything that got there. In case of an allergic cough in children and adults, the allergen enters the respiratory tract, to which their body reacts as an alien from another galaxy.
Causes of an allergic cough in children - allergens
Among the causes of allergic cough in children, doctors call such typical irritants as dust, pollen of flowering plants, animal fur (cats, dogs, guinea pigs, hamsters), bird feathers (parrots and canaries in a cage or down-padded "stuffing" pillows) spores of mold fungi and bacteria that enter the child's body through the mucosa of the upper respiratory tract. Therefore, an allergic cough can begin not only in spring or summer, but at any time of the year.
Dry allergic cough in children is very often a protective reaction of the body to ticks that live in ... Ordinary house dust. So, according to medical statistics, the etiology of bronchial asthma in 67% of children who have this diagnosis is an allergy to dust mites. By the way, in our apartments (in mattresses, blankets, pillows, carpets, books, upholstered furniture) live the hordes of these microscopic arachnids - almost 150 species of dermatophagoid or pyroglipid ticks. Their main food is the systematically peeling particles of the upper layer of the human skin (epidermis). Wastes of mites (excrement) contain proteins, which cause allergic reactions in people with increased sensitivity.
The greatest tendency to allergy, including in the form of a cough, was noted in children who had diathesis in infancy (a violation of adaptation with frequent allergic reactions and reduced resistance to infection). According to doctors, these children are predisposed to allergies from birth.
It should also be borne in mind that the probability of the occurrence of an allergic cough in children is higher where there are people in the family who suffer from allergies. Allergic cough is most often diagnosed in children aged one to seven years.
Symptoms of an allergic cough in children
The main feature of an allergic cough in children is that it has a clinical picture, which in some ways resembles a cough in acute respiratory diseases. That's why it is often taken for the sign of a cold or ARVI.
However, an allergic cough, as a rule, begins at normal body temperature. At the same time, the child feels unwell: becomes listless, easily irritated and more capricious. Attacks dry, tearing larynx painful coughing occur unexpectedly, mostly at night. Coughing can be accompanied by itching in the throat and nose, sneezing and a slight runny nose. With prolonged bouts of coughing, a child may start expectoration of clear phlegm, but it does not become easier for him. The child breathes with a whistle (with exhalation) and complains of chest pain when coughing.
The main zone of allergic inflammation, the manifestation of which is an allergic cough in children - larynx and trachea, and this allergic laryngotracheitis. If
Defeat allergen inflammation is localized in the pharynx, then the doctors diagnose allergic pharyngitis. Allergic laryngitis is determined by inflammation of the larynx, allergic tracheitis - in the inflammatory process in the trachea, allergic bronchitis - in the bronchi.
The disease can be aggravated repeatedly during the month, in the fall and winter it happens more often. And parents need to remember that with such symptoms of an allergic cough in children, "treating colds" with mustard plasters, rubbing or herbal decoctions from coughing is a waste of time. And you can not lose it, because such a cough without adequate treatment can go to chronic obstructive bronchitis, and then - into bronchial asthma.
Diagnosis of an allergic cough in children
To reveal the real cause of an allergic cough can only the doctor-allergist. For this purpose, a child's examination is carried out, including a whole set of laboratory tests (general blood test, sputum smear from nose to eosinophils), finding out the state of respiratory organs and the pathological processes occurring in them (using computer bronchophonography), as well as allergen tests.
But the paramount task of diagnosing an allergic cough in children is to determine the allergen (or allergens) that causes the disease. And here comes to the rescue a proven method - allergic skin tests (skin testing). They are made on pollen of plants, household allergens, and also on medicinal irritants - to children at the age of four years and older.
Another method of diagnosis in allergology is the enzyme immunoassay (ELISA). This method allows to detect and measure the number of specific antigens that the body produces and releases into the blood plasma in response to the penetration of foreign cells. By the type of antigen it is possible to find out which allergen caused such a reaction of the organism.
The most modern method of diagnosing allergies, including the diagnosis of allergic cough in children, is the method of multiple chemiluminescence - MAST. Comparing the allergen (or several allergens) detected in the patient with a whole set of standard allergens, you can put the most accurate diagnosis, even with hidden forms of allergy.
Treatment of an allergic cough in children
Complex treatment of allergic cough in children is aimed at reducing sensitivity to allergen (desensitization), getting rid of it as far as possible (immunotherapy), as well as on the removal of symptoms - bronchospasm.
To reduce sensitivity to the allergen, as a means of general treatment of allergic cough in children, antihistamines (antiallergic) drugs are used. They block histamine - the mediator of human reactions to allergens.
It should be noted that often prescribed antiallergic drugs of the first generation (diphenhydramine, diprazine, suprastin, pifen, pipolfen, tavegil) have not only a sedative (sedative) effect and cause drowsiness. Among the negative side effects of these popular drugs, their effect on the formation of neural connections in children, even at moderate therapeutic doses, is found. In addition, taking these medications leads to dryness of the mucosa of the respiratory tract, that is, cough may become more intense with thick sputum in addition. It is for this reason that these medicines give children a maximum of five days. For example, Tavegil (he is also Clemastin) is strictly contraindicated for children up to a year. And children under 12 years of age are prescribed 0.5 tablets 2 times a day (before meals, with a small amount of water).
At antihistamines of last generation - klaritina, fenistila, zirteka, kestina - there is no sedative effect. So, klaritin (it's lomilan, loparen, clallergine, etc.) is released in the form of tablets and syrup. The dose of the drug for children from 2 to 12 years - 5 ml of syrup (1 teaspoon) or half a tablet (5 mg) with a body weight of not more than 30 kg; for children over 12 years, the daily dose is 1 tablet (10 mg) or 2 teaspoons of syrup.
The best, although the longest (within three to five years) treatment of any allergy and allergic cough in children is allergen-specific immunotherapy (ASIT), which "accustoms" the body's immune system to allergens. The method is based on the introduction of the patient gradually increased doses of the same allergen, which causes an allergic reaction. According to allergists, as a result of this treatment, the immune system simply ceases to respond to a previously not tolerated stimulus.
Symptomatic treatment of allergic cough in children is done with the help of antispasmodics, which, reduce or completely relieve spasm of the bronchi and coughing attacks. The preparation berotek in the form of 0,1% solution for inhalation counteracts the development of bronchospastic reactions. It is prescribed to children of 6-12 years for 5-10 drops, over 12 years - 10-15 drops per inhalation. Inhalations are conducted no more than four times a day, before use, the drug should be diluted in one teaspoon of saline.
Effective expectorant solutan (solution for ingestion) is taken by children from one to six years for 5 drops three times during the day; from 6 to 15 years - 7-10 drops. Children 2-6 years are better to use an aerosol for inhalation salbutamol (ventolin) - 1-2 mg 3 times a day.
Cough syrup glycogen with terpinhydrate and levomenthol should be taken 3-4 times a day: children aged 4-6 years - a quarter teaspoon, 7-12 years, half a teaspoon. A prepatat fluifort in the form of syrup has mucolytic (thinning phlegm) and expectorant effect. Children aged 1 to 5 years are prescribed half the teaspoon 2-3 times a day, the older children are given a teaspoon three times a day.
Prevention of allergic cough in children
Prevention of allergic cough in children is possible and depends only on the consistency and perseverance of parents. Daily wet cleaning in the house, especially in the children's room, should become the rule without exception. Air in the apartment is recommended to clean and control its humidity.
In the room where the child lives, suffering from an allergic cough, there is no place for wool carpets and carpets, fabric curtains, soft couches or armchairs, as well as room colors. Even plush and fur toys in this room should not be, let alone live "carriers of wool" - a dog or a cat.
For the prevention of allergic cough in children, woolen blankets and feather pillows will have to be replaced with bedding made from hypoallergenic artificial materials. A linen on the bed of the child should be changed twice a week and subjected to thorough washing in very hot water.