Pollinosis in children

Hay fever in children is largely genetically determined by the key link in pathogenesis - increased synthesis of IgE.

It has been proven that the ability to produce increased IgE is inherited in a recessive dominant manner and is a necessary, but not the only condition for the development of pollen allergy. Positive associations of hay fever diseases with HLA B-7, B-8, B-12 have been identified. In most children with hay fever, it is preceded by early skin symptoms of allergy, food allergy, and early production of reagins (IgE) in increased quantities.

In the pathogenesis of pollinosis in children, a role is played by a deficiency of secretory IgA, a disruption of the barrier functions of the upper respiratory tract, a disruption of the local protective function of macrophages and granulocytes, and a decrease in the production of a substance that inhibits the activity of the pollen permeability factor.

According to researchers, the leading role in the etiology of hay fever in children is played by pollen of cereal grasses, increased sensitivity to which was found in 75% of those examined, somewhat less often, but still quite often - tree pollen (in 56% of patients) and 27% of children were found to be sensitized to weed pollen (wormwood, quinoa). In 64% of children with hay fever, the disease develops as a result of polyvalent allergy.

Plant pollen allergens are classified as aeroallergens. Of the many thousands of plants on Earth, only about 50 produce pollen responsible for hay fever. Sensitization is caused by male reproductive elements of mainly wind-pollinated plants. The grains of these types of pollen are round and no more than 35 microns in diameter. Sensitization in each geographic zone occurs to the pollen of widespread plants that produce huge amounts of pollen (one ragweed bush produces up to 1 million pollen grains per day).

There are three main groups of allergenic plants:

• woody;
• cereals;
• mixed grass (weeds).

The first spring peak of high frequency of pollen allergy (April-May) is caused by tree pollen: hazel, alder, oak, birch, ash, walnut, poplar, maple, etc. The role of pine and spruce pollen in the occurrence of allergic diseases of the respiratory tract is small.

The second summer increase in pollen concentration (June-August) is associated with the flowering of cereals: bluegrass, couch grass, brome grass, fescue, hedgehog grass, foxtail, rye, corn, etc. The flowering season of these grasses coincides with a high concentration of poplar fluff in the air, which is often mistaken by patients for a reaction to fluff.

The third autumn peak of pollen allergy (August-October) is caused by plants with the greatest allergenic activity. These include weeds: ragweed, quinoa, dandelion, hemp, nettle, wormwood, buttercup, etc.

What causes hay fever in children?

Symptoms of pollinosis begin with rhinoconjunctival symptoms. The onset of the disease coincides with the pollination of plants that are an allergen for the child, allergy symptoms, as a rule, recur at the same time every year. Itching and burning of the eyes appear, simultaneously with itching or before it, lacrimation, swelling of the eyelids, hyperemia of the sclera are noted. Itching may be in the nose area, scratching of the nose with hands is observed (the so-called "allergic salute"). Paroxysmal sneezing, profuse watery discharge from the nose, difficulty in nasal breathing are characteristic. Clinical manifestations persist throughout the flowering period of plants that are allergens. In winter and autumn, patients do not present complaints. A significant difference between pollen conjunctivitis and other inflammatory diseases of the mucous membrane of the eyelids is the scarcity of discharge.

Symptoms of hay fever

The diagnosis of pollinosis is established on the basis of typical clinical manifestations of the disease in the spring and summer. Rhinoscopically, pale or bluish color of the nasal mucosa, enlargement of the inferior turbinate are determined. The presence of clinical and anamnestic signs of pollinosis is the basis for an allergological examination (carried out outside the pollen season). Since, regardless of the place of synthesis, allergen-specific IgE antibodies are evenly distributed in the skin, nasal mucosa and serum of patients, endoprosthetic or conjunctival provocation tests (as indicated), prick test and skin scarification tests, determination of specific IgE are carried out. During an exacerbation, a large number of eosinophils can be determined in smears of nasal secretions, persistent eosinophilia of peripheral blood (12% or more).

Diagnosis of hay fever

For effective treatment of pollinosis, along with rational pathogenetic therapy, an important role is played by the regime of maximum possible limitation of the level of antigen stimulation. During the period of remission, the main and most effective method of treating patients with pollinosis is specific hyposensitization.

Pollen elimination is not possible.

How is hay fever treated in children?

[ 1 ], [ 2 ], [ 3 ], [ 4 ]