Children's allergist
Allergies, that is, excessive reaction of the immune system to substances harmless to most people, has become one of the most common diseases in the world. According to the World Organization of Allergy (World Allergy Organization), to date, the allergy is a disappointing diagnosis of 20-30% of the inhabitants of our planet.
According to the American Council of Allergy and Immunology (ABAI), 50 million Americans - including millions of children - suffer from allergies. In Europe, the number of allergies has reached 150 million, and allergic disorders, which are affected by about a third of European children, rank first among children's chronic diseases. Thus, in Switzerland 11.2% of children are patients of children's allergists. Among children of British families, almost 50% have some form of allergy (more than 8% of them suffer from food allergy, which doctors call food intolerance).
So a special doctor - a child allergist - is necessary to provide optimal treatment and improve the condition of small patients.
Who is a child allergist?
A child allergist or physician, an allergist-immunologist, is a specialist with a higher medical education in a separate field of clinical medicine, which is called allergology. This section of medicine studies allergic reactions and associated diseases, their etiology, developmental mechanisms and symptoms, as well as methods of diagnosis, treatment and prevention.
Children's allergist takes into account the characteristics of the child's organism on the basis of fundamental training in pediatrics, which deals with childhood diseases and caring for healthy and sick children of any age. Therefore, children's allergists know how to effectively and safely help their patients.
Children's allergists are trained to treat the symptoms of food allergies, and can provide professional help to parents to prevent exacerbations of the disease and reduce allergic symptoms - using a special elimination or individually selected hypoallergenic diet.
When should I contact a pediatric allergist?
Specialists note that the most common allergic reaction in children is allergic rhinitis. Although the child's allergic reactions to plant pollen, medicines, pet dander, dust mites, household chemicals and certain foods, show the same symptoms as adults.
It should be borne in mind that any child can become allergic, but children from families in which one of the relatives has an allergy can inherit this disease with a probability of up to 40%. This does not mean that such children are doomed to active development of this disease, but children's allergists advise to pay attention to the main symptoms of allergy. These include: violation of nasal breathing, itching of the nose and palate, sneezing and runny nose; edema and hyperemia of the conjunctiva, itchy eyelids and lacrimation; often repeated night dry cough; wheezing in the chest and shortness of breath (up to shortness of breath and attacks of suffocation); itchy skin rashes.
As a rule, one of these signs of allergy manifests, without changing the body temperature. So parents need to be careful and with similar, seemingly "unreasonable" reactions of the child to turn to a specialist - a child allergist.
Moreover, the lack of timely treatment of allergies of any etiology can lead to the most serious complications.
What tests should I take when I contact a pediatric allergist?
Almost all the symptoms of a true allergy can be signs of a large number of other diseases, so when you contact a pediatric allergist you will need a general clinical blood test. This analysis will allow the physician to objectively assess the child's overall health status - based on hemoglobin concentration data; number of leukocytes, erythrocytes and platelets; erythrocyte sedimentation rate (ESR) and other indicators. A general blood test will provide information on the presence of infectious, inflammatory processes in the body, will identify viral and bacterial diseases.
A child allergist can also send a blood test to the level of eosinophil content, general sputum analysis and a smear from the nose to eosinophils. It is often recommended to go through spirography - to determine the reaction of the bronchi and clarify the cause of the cough (as night cough is with many other pathologies, for example, with hypertrophy of the nasopharyngeal tonsil - adenoids).
To determine the correct diagnosis, especially with suspicions of pollinosis or atopic bronchitis, data from an x-ray examination of the paranasal sinuses of the nose or lungs are often used. In addition, with helminthic invasion, the sensitivity of the child's organism to various antigens increases, therefore, the analysis of feces for eggs of helminths may be prescribed.
What diagnostic methods does the child allergist use?
At present, two key special diagnostic methods are used in domestic pediatric allergology, and both are aimed at identifying allergens - substances that cause an inadequate response of the immune system.
Skin-allergic tests or skin testing for allergens of various types are conducted to children no earlier than 4 years of age. When skin allergic diseases are put on application skin tests: a piece of sterile bandage (about 1 square centimeter) moistened with an allergen solution is applied to the skin of the forearm or back (where there are no rashes), covered with film or cellophane and fixed with adhesive plaster. The results are evaluated after 20 minutes, after 5-6 hours and after 1-2 days.
Scarification skin and allergic tests are also performed, in which droplets of special preparations with specific allergens are applied to the inner side of the forearm and small drops are made in each drop on the skin (each scratch is done by a separate scarifier or end of the needle). The results are evaluated after 15-20 minutes. Allergists emphasize that scarification skin tests are carried out with suspicion of the presence of pollinosis, allergic rhinitis, atopic form of bronchial asthma, urticaria and Quincke edema in patients - that is, with a reactive (E-dependent) immediate type of reaction.
The second main diagnostic method, widely used by a children's allergist, is an enzyme immunoassay (ELISA), which determines the total serum immunoglobulin and specific antibodies (IgE). This method of diagnosing allergies is considered more accurate, and its results are practically unmistakable.
In addition, among diagnostic methods used by a child allergist, provocative tests: a nasal test for the diagnosis of allergic rhinitis (determination of eosinophilia-level of eosinophilic leukocytes in a mucous secret) and a conjunctival test (a test for detecting an immediate hypersensitivity of the conjunctiva to an allergen). Inhalation test (inhalation of a small amount of a certain allergen in a low concentration - to detect atopic bronchial asthma) is performed during the period of remission of the disease and exclusively in a hospital.
What does a child allergist do?
The task of every child allergist is to put the right diagnosis and prescribe an adequate treatment of allergic diseases and pathological malfunctions of the immune system in children.
Allergy is a systemic disease, and, for the same symptoms, there may be different causes. And the children's allergist is engaged in the identification of these causes, that is, specific allergens, in children of all age categories - from infants to adolescents.
So, in infants allergic dermatitis (diathesis) is very often, because the digestive system of infants is in the process of formation. And usually a non-immunological skin reaction is associated with the beginning of complementary feeding, when new products start to be introduced into the diet of a baby who is breast-feeding: cow's milk and dairy products, cereals, eggs, vegetables, fruits. And in older children, an allergic reaction in the form of nasal congestion and rhinitis is due to the ingress of allergens of protein origin through the respiratory system.
In any case, a child allergist will carefully examine the child and hold an anamnesis collection - that is, he will inquire about the presence of allergic diseases in the family, ask his mother about the course of the pregnancy and the birth. And if there is a need, the doctor will conduct a special allergological (immunological) examination.
What diseases are treated by a child allergist?
To diseases, the treatment of which falls within the competence of a child allergist, absolutely all manifestations of an allergic reaction of the body and allergies of any etiology are. This is pollinosis (seasonal allergic rhinitis or hay fever), allergic rhinitis, allergic conjunctivitis, allergic bronchitis and atopic bronchial asthma, urticaria, atopic dermatitis, allergic dermatosis (including drug toxicosis), serum sickness, angioedema, edema of Quincke.
Tips of a pediatric allergist
Allergy is a very serious disease, so it is impossible to engage in self-medication. Especially since it is impossible to cure an allergy, but you can only remove its symptoms.
Any drug from an allergic cough, allergic rhinitis or urticaria should be prescribed by a child allergist, otherwise parents risk their child's health.
Parents need to remember that to minimize the risk of developing a newborn baby's allergic reactions helps natural feeding. Therefore, it is necessary to feed the baby with breast milk as long as possible and up to five months not to give him animal proteins, and up to a year - cow's milk. New products in the diet of young children are introduced one at a time, starting with a small number.
The best detergent for a young child is a baby soap with no additives. Before putting on new clothes, it must be washed. The apartment must be clean: dust and mold are very common and dangerous allergens. Carpets and soft (fur and plush) toys can harm the health of a child prone to allergies.
In the case of the slightest suspicion of allergy, you need to seek specialized medical help, which is provided only by a children's allergist.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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