Symptoms of hay fever

Symptoms of hay fever begin with rhinoconjunctival symptoms. The onset of the disease coincides with the dusting of plants that are allergens to the baby, allergy symptoms are usually repeated at the same time each year. There is itching and burning eyes, at the same time with itching or before it, there are lacrimation, puffiness of the eyelids, hyperemia sclera. Itching can be in the nose area, there is scratching of the nose (so-called "allergic salute"). Characteristic sneezing, abundant watery discharge from the nose, difficulty in nasal breathing. Clinical manifestations persist throughout the flowering period of plants that are allergens. In winter and autumn, patients do not complain. A significant difference between pollen conjunctivitis and other inflammatory diseases of the mucous membrane of the eyelids is the scarcity of the discharge.

Isolated rhinitis is extremely rare. Usually, the pathological process extends to the paranasal sinuses, nasopharynx, auditory tubes, larynx. Complaints about itching in the ears, pharynx, trachea, choking, coughing, desire to clear throat. Attacks of sneezing and sensation of something foreign in the throat due to the sharply increased sensitivity of the nasopharynx can arise from dust, odors, and draft. Along with the main clinical manifestations of pollinosis with polyvalent sensitization may be seasonal urticaria, Quincke edema, allergic dermatitis.

The defeat of the nasal mucosa without the involvement of paranasal sinuses in children is very rare. In patients with pollinosis, sinusitis usually occurs without specific clinical symptoms. Children complain of stuffy nose, sneezing attacks, itching in the nose, eyes, pharynx. Objectively, there are puffiness of the face, swollen nose, maceration of the skin of the vestibule of the nose. In the cytogram of the contents of the sinuses and the nasal cavity, eosinophils predominate. Eosinophilia grows during the period of exacerbation and decreases during the process of subsidence. An important distinctive feature of pollen rhinosinusitis is the absence of dystrophic changes in the mucous membranes, even with many years of illness.

When nasopharyngitis complaints of painful sensation of burning and itching in the pharynx, with a rhinoscope, diffuse edema of the nasopharynx mucosa and its lymphoid formations (adenoids). Edema adenoids can cover the mouth of the Eustachian tubes and in such cases, complaints of obstruction of the ears, a decrease in hearing are characteristic for the eustachyte. When otoscopy is determined by the tympanic membrane.

The main complaint of patients with allergic tracheobronchitis is an obsessive, paroxysmal cough, often accompanied by vomiting in children. AD Zisselson, 39% of children with pollinosis had bronchial asthma, while none of the children had pollen asthma without concomitant rhonoconjunctivitis. According to TS Sokolova et al., Pollen asthma developed in 22% of untreated children with pollinosis and only 4.7% of those treated. In children, a seizure of bronchial asthma is usually preceded by a period of precursors. With pollinosis this period is characterized by aggravation of the severity of rhinoconjunctival and asthenovegetative syndromes, the appearance of a spasmodic cough. Knowledge of patient-specific features of the entrepreneurial period makes it possible to conduct preventive therapy.

Bronchial asthma in patients with isolated pollen sensitization is characterized by a clear seasonality of exacerbations, which coincides with the time of dusting of the corresponding allergens after a number of years of manifestation of pollinosis in the form of rhinoconjunctival syndrome, tracheobronchitis. Attacks of bronchial asthma develop with a massive inhalation of pollen allergens during a walk, which is of great importance for the diagnosis and precisely the pollen etiology of asthma. In children with combined household and pollen sensitization, periods of exacerbation of asthma occur year-round, while in the spring-summer period the intensity of antigenic stimulation is increased due to the influence of pollen allergens, and in the autumn-winter period dust allergens and epidermal (contacts with domestic animals) are important.

AD Zisselson among 300 children with pollinosis in 29% of cases noted the manifestations of allergic dermatitis, but only 14% had been proven pollen etiology of skin lesions. Relatively higher frequency of allergic dermatitis of pollen etiology in childhood, the author explains the age, immaturity of the barrier functions of the skin, its increased vulnerability. In children with pollen etiology, allergic dermatitis exacerbation of the skin process had a clear, seasonal recurrence from year to year, coinciding with the period of flowering plants, and the skin syndrome, as a rule, combined with rhinoconjunctivitis.

[1], [2], [3], [4], [5], [6]