Frequency of functional disorders of the biliary tract in children with atopic dermatitis
Background. According to the data of numerous authors, the severity of atopic dermatitis (AD) strongly depends on the functional state of the digestive system. The purpose of the study is to analyze frequency and peculiarities of atopic dermatitis course in children with disorders in the biliary system. Materials and methods. A total of 168 children aged 1 to 18 years old with AD were studied. Diagnosis of AD in children was verified according to the diagnostic criteria of J.M. Hanifin and G. Rajka (1980). All patients and their parents were questioned using a survey record. General and specific IgE (pediatric panel) was determined. State of the biliary system was assessed using ultrasonography, biochemical parameters of blood serum. Statistical processing of research results was performed using standard algorithms of variation statistics. Results. According to the questionnaire results, the following risk factors for the development of AD in children and adolescents are found: burdened heredity (53.5 %), allergic manifestations during the 1st year of life (62.5 %), high IgE levels (52.3 %); factors causing exacerbation of AD (triggers): mixed allergens — 23.8 %, food allergens — 71.4 %, medicinal allergens — 17.8 %, household allergens — 5.9 %, pollen allergens — 3.4 %, temperature factor — 1.7 %, psychoemotional factor — 1.7 %, not specified — 24.6 %; artificial feeding from birth (13.1 %); the total duration of manifestation: up to a year — 11.3 %, from 1 to 5 years — 44.9 %, from 5 to 10 years — 23.8 %, more than 10 years — 20.3 %. The mean scoring value for SCORAD in patients with mild AD levels was 14.01 ± 0.63 points, with an average grade of AD of 31.04 ± 0.92 points, and in patients with severe degrees of 56.17 ± 5.23 points. The average score on the EASI scale in the examined patients aged 5 to 7 years was 8.67 ± 0.46 points. The elevated IgE level was registered in 52.3 %. The active survey and observation revealed the signs of functional disorder of the biliary tract in the majority of patients — 109 (64.8 ± 3.2 %) children. The ultrasound examination demonstrated gallbladder dysfunction in 45 (42.8 %) out of 109 children with complaints. Increase liver (up to 10 %) without changes in echostructure and echogenicity was observed in 26 (23.8 ± 0.8 %) children with AD. Conclusions. Given a high frequency of functional disorders of the biliary tract in children with AD, it is recommended to perform an ultrasound examination of the hepatobiliary system and to make the appropriate correction of the revealed violations in the complex treatment of AD on the basis of the obtained data.
Full Text:PDF (Українська)
Ellwood P, Asher MI, Beasley R, Clayton TO, Stewart AW; ISAAC Steering Committee. The International Study of Asthma and Allergies in Childhood (ISAAC): Phase Three rationale and methods. Int J Tuberc Lung Dis. 2005 Jan;9(1):10-6.
Bridgman AC, Eshtiaghi P, Cresswell-Melville A, Ramien M, Drucker AM.The Burden of Moderate to Severe Atopic Dermatitis in Canadian Children: A Cross-Sectional Survey. Cutan J Med Surg. 2018 Jul/Aug; 22(4): 443-444. doi: 10.1177/1203475418761859.
Kryuchko TO, Holovanova IA, Tkachenko OY, Melnyk MO, Pocheniuk KV. Prevalence of risk factors of allergic diseases among children aged 8-9 years in poltava region (the results of the first stage of the research). WiadLek. 2018; 71(3 pt 2):699-704.
Kunsleben N, Rüdrich U, Gehring M, Novak N, Kapp A, Raap U. IL-31 Induces Chemotaxis, Calcium Mobilization, Release of Reactive Oxygen Species, and CCL26 in Eosinophils, Which Are Capable to Release IL-31. J Invest Dermatol. 2015 Jul; 135(7):1908-11. doi: 10.1038/jid.2015.
Schmitt J, Chen CM, Apfelbacher C, et al. Infant eczema, infant sleeping problems, and mental health at 10 years of age: the prospective birth cohort study LISAplus. Allergy. 2011 Mar; 66(3):404-11. doi: 10.1111/j.1398-9995.2010.02487.x.
Kobetz TV, Gostishcheva EV. Analysis of combined pathology: atopic dermatitis and functional disorders of the biliary system in children. Vestnik fizioterapii i kurortologii. 2011;17(3):66-67. (in Russian).
Okhotnikovа OM, Bondarenko LV, Ivanova TP, et al. Gastrointestinal dietary allergy in the children as the up-to-date issue. Sovremennaya pediatriya. 2014;(64):104-109. doi 10.15574/SP.2014.64.104. (in Ukranian).
Hanifin JM, Thurston M, Omoto M, Cherill R, Tofte SJ, Graeber M. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol. 2001 Feb;10(1):11-8. doi: 10.1034/j.1600-0625.2001.100102.x.
Copyright (c) 2019 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019