Background: “atopic march” (AM) is the natural history of allergy mostly in children. The aim: to describe the production of biomarkers of allergic inflammation in dependence on the duration of AD. Patients and methods. 94 children suffered from atopic dermatitis (AD) have been included to the study. The severity of the disease has been estimated, serum level of total IgE, IL-4, interferon gamma and sIL-2R have been estimated. Results. Coexistence of AR and AD was diagnosed in 32/94 (34.0%) patients. Less severity of AD (SCORAD 32.3 ± 9.17 score vs 22.2 ± 2.29 score, p < 0.05), but higher serum level of total IgE (Ме 123 [Q1-Q3 67–156] IU/ml vs Ме 53 [Q1-Q3 5–108] IU/ml, р < 0.001), IL-4 (Ме 12.0 [Q1-Q3 8.7–16.1] pg/ml vs Me 6.0 [Q1-Q3 2.2–12.1] pg/ml, р = 0.0399) and sIL-2R (Ме 2.1 [Q1-Q3 0–20] IU/ml vs Me 0 [Q1-Q3 0–12.9] IU/ml, р = 0.3365) are detected in comorbid patients. Eposides of wheezing are associated with additional risk of AD (OR 2.3 [95% CI 1, 18–4,54]). Discussion. The development of AR in children with AD is considered as progression of natural history of allergy. In our study it was associated with higher level of IgE, IL-4 and sIL-2R. At the same time the comorbid patients had less severity of AD. Conclusion. The coexistence of AD and AR in 3-year-old children is associated with less severity of skin symptoms but higher frequency of sensitization to inhalant allergens than in AD. AM is accompanied by higher production of Th2-dependent parameters and markers of early activation of T-cells. The probability of the AM is higher in 2 times if there were wheezing episodes in the anamnesis.
Aim. To identify the pecularities of clinical, functional features and morphological characteristics in children with subatrophic gastroduodenitis after eradication treatment.Methods. Gastrointestinal tract condition was examined in 26 children with subatrophic gastroduodenitis. Esophagogastroduodenoscopy with morphological analysis of biopsy specimens, esophageal pH test and urea breath test were performed.Results. 16 (60.7%) children reported low-grade pain, severe pain occurred in 3 (11.5%) patients, no abdominal pain was reported in 7 (27.6%) patients. A biopsy specimen was gained in 22 patients; moderate contamination with H. pylori was detected in 13 (59%) patients, severe - in 9 (41%) patients. Breath test was positive in all patients (n=26). Morphological study revealed fibrotic changes in 14 (63.6%) patients, atrophy and sclerosis lesions - in 7 (31.8%) and 17 (77.3%) patients, respectively, in addition to clear signs of inflammation. Intestinal metaplasia of the gastric mucosa was discovered in 4 (18.2%) children. Candidiasis of the stomach and duodenum was diagnosed in 7 (31.8%) children. All patients were administered standard eradication treatment. Repeated breath test after 4 weeks was positive in 9 (41%) patients, including 7 (31.8%) who were diagnosed with candidiasis by biopsy test. At 12 months, the control endoscopy performed in 19 patients: 5 patients, who failed to follow the recommendation, had marked clinical and endoscopic signs of relapse, no patients with good treatment compliance (n=14, 73.6%) had any clinical manifestations, although endoscopic signs of inflammation preserved in 9 (47.4%) children. Biopsy with histological examination was repeated in 9 patients. Signs of inflammation were significantly reduced in 6 (66.7%) patients, while the foci of atrophy, sclerosis and intestinal metaplasia retained in 2 out of 9 children. Contamination with H. pylori had significantly decreased.Conclusion. Endoscopic signs of gastroduodenal chronic inflammation correspond to the severity of morphological characteristics in the acute stage of gastroduodenitis. Children with preserved signs of intestinal metaplasia of gastric and duodenal mucosa require intensive treatment and prolonged follow-up.
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