When diagnosing allergic diseases in children and adults, doctors pay special attention to collecting a patient's history. Sometimes knowledge of family diseases, predispositions to allergies and food intolerances greatly facilitates the diagnosis. The article discusses the concept of an anamnesis about allergies, the features of its collection and significance.
Description
Allergic history is the collection of data on the allergic reactions of the organism under study. It is formed simultaneously with the clinical anamnesis of the patient's life.
Every year the number of complaints about allergies is growing. That is why it is important for every doctor to whom a person turns to know the reactions of his body in the past to food, medicines, smells or substances. Drawing up a complete picture of life helps the doctor quickly determine the cause of the disease.
This upward trend in allergic reactions is explained by the following factors:
- human inattention to their he alth;
- out of controldoctors taking medication (self-medication);
- insufficient qualification of doctors in the periphery (distant from the center of settlements);
- frequent epidemics.
Allergies manifest themselves differently in each person: from mild forms of rhinitis to edema and anaphylactic shock. It is also characterized by a polysystemic character, that is, the manifestation of deviations in the work of several organs.
The Russian Association of Allergists and Clinical Immunologists is developing recommendations for the diagnosis and treatment of various types of allergic reactions.
Purpose of history taking
Allergy history should be taken for each person. These are its main goals:
- determining the genetic predisposition to allergies;
- determination of the relationship between an allergic reaction and the environment in which a person lives;
- search and identification of specific allergens that could provoke pathology.
The doctor conducts a survey of the patient in order to identify the following aspects:
- allergic pathologies in the past, their causes and consequences;
- signs of an allergy;
- drugs that were previously prescribed and the speed of their effects on the body;
- correlation with seasonal phenomena, living conditions, other diseases;
- relapse information.
History tasks
When collecting an allergic history, the following tasks are solved:
- Establishing nature and formdiseases - identifying the relationship between the course of the disease and a specific factor.
- Identification of concomitant factors that contributed to the development of pathology.
- Identification of the degree of influence of household factors on the course of the disease (dust, dampness, animals, carpets).
- Determination of the relationship of the disease with other pathologies of the body (digestive organs, endocrine system, nervous disorders, and others).
- Identification of harmful factors in professional activities (the presence of allergens in the workplace, working conditions).
- Identification of atypical reactions of the patient's body to medicines, food, vaccines, blood transfusion.
- Assessing the clinical effect of previous antihistamine therapy.
When complaints are received from a patient, the doctor conducts a series of studies, a survey and examination, after which he establishes a diagnosis and prescribes treatment. With the help of tests, the doctor determines:
- Clinical and laboratory studies (general blood tests, urine tests, radiography, respiratory and heart rate indicators), which allow you to identify where the process is localized. This can be the respiratory tract, skin, eyes and other organs.
- Nosology of the disease - whether the symptoms are dermatitis, hay fever or other forms of pathology.
- The phase of the disease - acute or chronic.
Data collection
Taking an allergy history involves a survey, which takes some time and requires care, patiencefrom doctor and patient. Questionnaires have been developed for this, they help to simplify the process of communication.
The history-taking scheme is as follows:
- Determination of allergic diseases in relatives: parents, grandparents, brothers and sisters of the patient.
- Compiling a list of past allergies.
- When and how allergies manifested.
- When and how did drug reactions occur.
- Determination of connection with seasonal phenomena.
- Identification of the influence of climate on the course of the disease.
- Identification of physical factors in the course of the disease (hypothermia or overheating).
- Influence on the course of the disease of physical activity and fluctuations in the patient's mood.
- Identifying links to colds.
- Identification of the connection with the menstrual cycle in women, hormonal changes during pregnancy, breastfeeding or childbirth.
- Determination of the degree of allergy manifestation when changing places (at home, at work, in transport, at night and daytime, in the forest or in the city).
- Determination of the relationship with food, drinks, alcohol, cosmetics, household chemicals, contact with animals, their impact on the course of the disease.
- Determination of living conditions (presence of mold, wall material, type of heating, number of carpets, sofas, toys, books, presence of pets).
- Conditions of professional activity (factors of hazardous production, change of job).
Usually pharmacological and allergic historygather at the same time. The first shows which drugs the patient was taking before seeking medical help. Allergy information can help identify medical conditions caused by medications.
Acquisition of anamnesis is a universal method for detecting a disease
Collecting an allergological history is carried out, first of all, for the timely detection of a pathological reaction of the body. It can also help determine which key allergens a patient is reacting to.
Through the collection of information, the doctor determines the risk factors, concomitant circumstances and the development of an allergic reaction. Based on this, a treatment and prevention strategy is determined.
The doctor is obliged to take an anamnesis for each patient. Improper implementation of it can not only not help in prescribing treatment, but also aggravate the patient's situation. Only after receiving the correct test data, questioning and examination, the doctor can decide on the appointment of therapy.
The only drawback of this diagnostic method is the duration of the survey, which requires perseverance, patience and care from the patient and doctor.
History burdened / not burdened - what does it mean?
First of all, when examining a patient, the doctor asks about allergic reactions from his relatives. If there are none, then it is concluded that the allergic history is not burdened. This means no geneticpredisposition.
In such patients, allergies may occur due to:
- changing living or working conditions;
- colds;
- eating new foods.
All physician concerns about allergens should be explored and determined through provocative skin testing.
Often, patients have a family history aggravated by allergic reactions. This means that his relatives faced the problem of allergies and were treated. In such a situation, the doctor pays attention to the seasonality of the manifestation of the disease:
- May-June - hay fever;
- autumn - allergic to mushrooms;
- winter - reaction to dust and other signs.
Also, the doctor finds out whether the reactions were aggravated when visiting public places: zoo, library, exhibitions, circus.
Collecting data in the treatment of children
Allergic history in a child's medical history is of particular importance, because the child's body is less adapted to environmental risks.
When collecting information about diseases, the doctor pays attention to how the pregnancy proceeded, what the woman ate during this period and when breastfeeding. The doctor must exclude the ingress of allergens with mother's milk and find out the true cause of the pathology.
Example of a child's allergy history:
- Vladislav Vladimirovich Ivanov, born on 01.01.2017, a child from the first pregnancy, which occurred against the background of anemia,delivery at 39 weeks, without complications, Apgar score 9/9. In the first year of life, the child developed in accordance with age, vaccinations were put down according to the calendar.
- No family history.
- No previous allergic reactions.
- The patient's parents complain of rashes on the skin of the hands and abdomen that appeared after eating an orange.
- No previous drug reactions.
Collecting specific, detailed data about a child's life and condition will help the doctor make a faster diagnosis and choose the best treatment. It can be said that with an increase in the number of allergic reactions in the population, information about this pathology becomes more significant when collecting an anamnesis of life.
