Pediatric allergist

Allergy, that is, an excessive reaction of the immune system to substances that are harmless to most people, has become one of the most common diseases in the world. According to the World Allergy Organization, today allergy is a disappointing diagnosis for 20-30% of the inhabitants of our planet.

The American Board of Allergy and Immunology (ABAI) estimates that 50 million Americans – including millions of children – suffer from allergies. In Europe, the number of allergy sufferers has reached 150 million, and allergic disorders, which affect about a third of European children, rank first among chronic childhood diseases. For example, in Switzerland, 11.2% of children are patients of pediatric allergists. Among children of British families, almost 50% have some form of allergy (of which more than 8% suffer from food allergies, which doctors call food intolerance).

So a special doctor - a pediatric allergist - is needed to ensure optimal treatment and improve the condition of young patients.

Who is a pediatric allergist?

A pediatric allergist or allergist-immunologist is a specialist with higher medical education in a separate area of clinical medicine called allergology. This section of medicine studies allergic reactions and diseases associated with them, their etiology, development mechanisms and symptoms, as well as methods of diagnosis, treatment and prevention.

A pediatric allergist takes into account the characteristics of a child's body based on fundamental training in pediatrics, which deals with childhood diseases and care for healthy and sick children of any age. Therefore, pediatric allergists know how to effectively and safely help their patients.

Pediatric allergists are trained to treat the symptoms of food allergies and can provide professional help to parents to prevent flare-ups and reduce allergic symptoms – with a special elimination diet or an individually tailored hypoallergenic diet.

When should you see a pediatric allergist?

Experts note that the most common allergic reaction in children is allergic rhinitis. Although allergic reactions of the child's body to pollen, medications, pet dander, dust mites, household chemicals and certain food products manifest themselves with the same symptoms as in 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 the active development of this disease, but pediatric allergists advise paying attention to the main symptoms of allergy. These include: impaired nasal breathing, itching of the nose and palate, sneezing and runny nose; swelling and hyperemia of the conjunctiva, itching of the eyelids and lacrimation; frequently recurring dry cough at night; wheezing in the chest and difficulty breathing (up to shortness of breath and attacks of suffocation); itchy rashes on the skin.

As a rule, one of these allergy symptoms appears, and without a change in body temperature. So parents need to be attentive and, in case of such, at first glance "unreasonable" reactions of the child, contact a specialist - a pediatric allergist.

Moreover, the lack of timely treatment of allergies of any etiology can lead to the most serious complications.

What tests should be taken when visiting a pediatric allergist?

Almost all symptoms of a true allergy can be signs of a large number of other diseases, so when visiting a pediatric allergist, a general clinical blood test will be needed. This test will allow the doctor to objectively assess the child's general health - based on data on hemoglobin concentration; the 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, and will allow the detection of viral and bacterial diseases.

A pediatric allergist may also refer you for a blood test to check the level of eosinophils, a general sputum test, and a nasal smear to check for eosinophils. Spirometry is often recommended to determine the reaction of the bronchi and clarify the cause of the cough (since a night cough occurs with many other pathologies, for example, with hypertrophy of the nasopharyngeal tonsil - adenoids).

To determine the correct diagnosis, especially if pollinosis or atopic bronchitis is suspected, X-ray examination data of the paranasal sinuses or lungs are often used. In addition, with helminthic invasion, the child's body's sensitivity to various antigens increases, so a stool test for helminth eggs may be prescribed.

What diagnostic methods does a pediatric allergist use?

Currently, 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 allergy tests or skin testing for various types of allergens are performed on children no earlier than 4 years of age. In case of skin allergic diseases, application skin tests are performed: a piece of sterile bandage (about 1 sq. cm in size) soaked in an allergen solution is applied to the skin of the forearm or back (where there is no rash), covered with film or cellophane on top and secured with adhesive tape. The results are assessed after 20 minutes, after 5-6 hours and after 1-2 days.

Scarification skin allergy tests are also performed, in which drops of special preparations with specific allergens are applied to the inside of the forearm and shallow small scratches are made on the skin in each drop (each scratch is made with a separate scarifier or the end of a needle). The results are assessed after 15-20 minutes. Allergists emphasize that scarification skin tests are performed if there is a suspicion of hay fever, allergic rhinitis, atopic asthma, urticaria and Quincke's edema in patients - that is, with a reaginic (E-dependent) immediate type of reaction.

The second main diagnostic method, which is widely used by pediatric allergists, is the enzyme immunoassay (ELISA) of blood, which determines the content of total immunoglobulin and specific antibodies (IgE) in the serum. This method of allergy diagnostics is considered more accurate, and its results are practically error-free.

In addition, among the diagnostic methods used by a pediatric allergist, provocative tests should be mentioned: a nasal test for the diagnosis of allergic rhinitis (determination of eosinophilia - the level of eosinophilic leukocytes in mucous secretions) and a conjunctival test (a test to detect immediate hypersensitivity of the conjunctiva to an allergen). An inhalation test (inhalation of a small amount of a certain allergen in a low concentration - to detect atopic bronchial asthma) is carried out during the period of remission of the disease and exclusively in a hospital setting.

What does a pediatric allergist do?

The task of every pediatric allergist is to make a correct diagnosis and prescribe adequate treatment for allergic diseases and pathological immune system disorders in children.

Allergy is a systemic disease, and the same symptoms can have different causes. And a pediatric allergist deals with identifying these causes, that is, specific allergens, in children of all ages - from infants to teenagers.

Thus, allergic dermatitis (diathesis) is very common in infants, since the digestive system of infants is in the process of formation. And usually a skin reaction of a non-immunological nature is associated with the beginning of complementary feeding, when new products are introduced into the diet of a child who is breastfed: 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 a consequence of the entry of protein allergens through the respiratory system.

In any case, the pediatric allergist will carefully examine the child and collect anamnesis - that is, inquire about the presence of allergic diseases in the family, ask the mother about how the pregnancy and birth went. And if necessary, the doctor will conduct a special allergological (immunological) examination.

What diseases does a pediatric allergist treat?

The diseases, the treatment of which is within the competence of a pediatric allergist, include absolutely all manifestations of an allergic reaction of the body and allergies of any etiology. These are pollinosis (seasonal allergic rhinitis or hay fever), allergic rhinitis, allergic conjunctivitis, allergic bronchitis and atopic bronchial asthma, urticaria, atopic dermatitis, allergic dermatoses (including drug toxicoderma), serum sickness, angioedema (Quincke's edema).

Advice from a pediatric allergist

Allergy is a very serious disease, so you can't self-medicate. Especially since it is impossible to cure allergy yet, you can only relieve its symptoms.

Any medication for allergic cough, allergic rhinitis or urticaria should be prescribed by a pediatric allergist, otherwise parents risk their child's health.

Parents should remember that breastfeeding helps minimize the risk of allergic reactions in newborns. Therefore, you should breastfeed your baby for as long as possible and not give him animal proteins for up to five months, and cow's milk for up to one year. New products are introduced into the diet of young children one at a time, starting with small quantities.

The best detergent for a small child is baby soap without additives. Before putting on new clothes, they should be washed. The apartment should 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 case of the slightest suspicion of an allergy, you should seek specialized medical care, which is provided only by a pediatric allergist.