In the article we will consider that this is an atopic march.
Which of the parents has not encountered such a problem as redness and rashes on the baby's cheeks? And more and more often sounded diagnoses: diathesis, eczema and the like. However, today doctors have come to a consensus: children do not have eczema, and hyperreaction of the skin is nothing more than an atopic march, which in everyday life is usually called an allergy.
Definition
Appearing for the first time at an early age, this pathology no longer leaves the patient for life. What is an atopic march in children? It is a natural manifestation of the child's heredity.
Bronchial asthma, dermatitis (allergic), rhinitis (allergic) with conjunctivitis are interrelated diseases in their pathological and morphological bases and mechanisms of development. Starting at an early age with atopic dermatitis, in the future they can transform into each other or combine with each other. That is, we are talking about the same concept, but from differentallergy application points.
So, this triad of allergic diseases, changing in stages, is the atopic march in children.
In this case, the formation of hypersensitivity to a particular allergen and a change in the clinical form of the manifestation of the disease occur.
It must be remembered that timely detection of symptoms of atopy in a child and therapeutic treatment will prevent the development of a severe form of the disease and stop the progression of the atopic march.
Mechanisms of Allergy
Allergies today are common among both children and adults. Studies show that the number of patients with one or another type of allergy is constantly growing.
The leading mechanism of allergy that develops in childhood is atopic, or reaginic. The synthesis of antibodies of the IgE class, sensitive to allergens, provokes certain reactions in the body.
Atopy is a predisposition to the production of these same IgE antibodies, which is genetically determined. When allergens (usually of a protein nature) enter the body, even in small quantities, an allergic reaction of the body occurs.
What are the causes of the atopic march? An atopic child often already at birth has an increased amount of IgE, which is synthesized during fetal development. Often, allergic reactions appear already in the first months of his life, since the disease is often hereditary, "family" in nature.
Mostlycases, several allergic diseases are diagnosed simultaneously in one child. For example, in 90% of cases, against the background of allergic rhinitis, bronchial asthma subsequently develops.
In the atopic march, new types of sensitization are constantly emerging. That is, the process of producing antibodies by the human body upon contact with a new allergen.
The first sensitization in a child's life - food, manifests itself in the form of atopic dermatitis (most often develops in the first six months after birth).
From the 1st year of life, children have a reaction to allergens from house dust and animal hair. This further leads to the occurrence of conjunctivitis, rhinitis, and if it comes into contact with the skin, exacerbations of atopic dermatitis may occur.
At the age of two, an increase in the incidence of bronchial asthma is diagnosed.
By the age of 5-6, pollen sensitization is formed, the clinical symptoms of which are hay fever, asthma attacks and exacerbation of dermatitis (especially in summer), a secondary food allergy may appear.
What are the risk factors
Definitely, all allergic diseases are hereditary. If the family has, for example, hay fever, intolerance to certain types of drugs, bronchial asthma, then children are more likely to suffer from atopic dermatitis. In a word, with a genetic predisposition, even the course of pregnancy can be a provocative factor: what did the mother eat, was there a threat of miscarriage,whether she took any medications and so on. It turns out that, not yet born, the child is already quite possibly interacting with a potential allergen. Therefore, even when planning a pregnancy, a woman should insure herself, and, given the tendency to allergies in the family, try to limit herself in the use of certain products. Naturally, this does not mean a complete rejection of cow's milk, red berries, eggs and nuts, but the norm should be observed.
There are also constitutional peculiarities. For example, dermatitis is more severe and spreads faster in chubby children.
Also, allergies get worse, and dermatitis is more pronounced with bowel problems.
The problem of our society is the general availability and unreasonable use of antibiotics, which also lead to a general decrease in immunity and disruption of the intestinal microflora.
Another scourge of our society is malnutrition. As a result, we have a vicious circle, when one inevitably entails another, which, in turn, leads to an exacerbation of our diseases. It is important to identify the causes of atopy syndrome and atopic march.
Next, we will find out how and why the disease occurs in adults. After all, this is also a serious topic.
Causes of atopic march in adults: skin diseases; reaction to certain foods; hereditary predisposition; stress; exposure to chemical allergens. Atopy of the skin is a pathology that cannot be infected.
Symptoms of the disease
Atopic march is diagnosed if:
- The baby's skin is red, excessively dry, with a persistent rash, itchy excruciatingly.
- Rhinitis and conjunctivitis are seasonal or do not go away throughout the year. There is always a lot of mucus in the stuffy and itchy nose, the child sneezes, the eyes are red and watery.
- There are obvious symptoms of asthma: heavy breathing, there are moments of suffocation, persistent cough, bronchospasm. In severe cases, shortness of breath during physical activity often occurs.
- In the blood plasma, the concentration of immunoglobulin E is greatly increased, the amount of antibodies to various stimuli increases significantly.
Common diagnostic errors in this pathology
The following can be attributed here:
- Denial of atopy with normal IgE levels.
- Prescribing a diet to cleanse the body of foods to which the child may be allergic based only on the study of the amount of specific IgE (or specific IgG).
- Unnecessarily frequent (more than once a year) testing for the detection of IgE in serum.
- Undiagnosed presence of atopic comorbidities.
- Misdiagnosis (e.g., clinical signs of hypersensitivity to food, pollen allergens appear after direct contact with animals).
- No burdened heredity for allergic diseases has been identified.
Why is it so important not to miss the moment in the treatment of atopic dermatitis at an early age?
Already by the age of three, without proper treatment, atopic dermatitis can develop into bronchial asthma, also into allergic rhinitis, and these diseases are often hidden under the guise of others, such as bronchitis, and children are treated in infectious diseases hospitals. People come to the allergist already when asthma has developed.
Complex therapy in the treatment of atopic march
We have already figured out that dermatitis of the same name, allergic rhinitis with conjunctivitis and bronchial asthma are stages of one pathological process.
If the treatment was started in the early stages of the disease, the chances of stopping the disease increase very significantly:
- Maximum exclusion of exposure to allergens and factors that provoke atopic dermatitis. The triggers of the disease can be any standard food, mechanical, chemical and thermal stimuli characteristic of atopics.
- Elimination of visible skin reactions: antihistamines are prescribed, which heals the skin, reduces the manifestations of allergies; external agents (in the form of ointments) and internal are also used.
- Providing a hypoallergenic life: a special diet, limiting the child's contact with potential allergens.
- Timely treatment of chronic infections.
- Hardening, activities to improve immunity.
- Maintaining stable remission of existing chronic diseases (gastritis, pancreatitis, etc.)
- Mandatory control of endocrine pathologies.
- For the treatment of dermatitis, the appointment of a certain diet plays an important role in infancy. Any food that has a high allergenicity score should be excluded from the atopic diet (regardless of whether the food is allergenic specifically for your child).
- If it is impossible to completely exclude the impact of an allergen known to the doctor, ASIT therapy (allergen-specific immunotherapy) can be prescribed. This method consists in the fact that small doses of an irritant are regularly introduced into the child's body, causing a slow weaning from allergens. You can start treatment only from the age of five, it can last up to five years.
Autolymphocytotherapy as a way to treat this pathology
Autolymphocytotherapy is the most effective method for the treatment of atopic march. Designed for children over five years of age. This method consists in the fact that the vaccine, which is a mixture of the child's own lymphocytes obtained from his blood and saline, is injected subcutaneously into the forearm. The dose of the vaccine is gradually increased, the required course consists of 6-8 sessions, the treatment regimen is signed individually.
The effect of therapy does not occur immediately and depends on the individual characteristics of the organism.
What are clinical guidelines for treatment?
Another question that also worries parents of atopic children. Clinical guidelines for atopic march arespecially designed documents that help the doctor develop the correct treatment regimen for the patient's pathological condition. They also indicate the symptoms, prognosis of the disease and methods for their elimination.
These documents have been used for thousands of years used in medicine, based on the opinion of the entire period of the development of medicine, covering many millennia, developed based on the opinion of leading experts and evidence-based medicine.
Each doctor needs to know all the clinical recommendations in his segment, but they are still recommendatory in nature, thanks to which the specialist has the opportunity to build an individual approach to the patient.
Clinical guidelines also include alternative treatments, which helps to find the most effective method in a short time.
Doctors advice
In the presence of atopic march in children, clinical guidelines indicate that the disease is usually of an allergic nature. Sometimes it can be provoked by some kind of psycho-emotional shock, some diseases of the internal organs. About 50% of all newborns experience this problem in the first year of life.
To avoid the development of the disease in a child, parents need to adhere to basic preventive norms. Foods that cause allergies should be the minimum amount in the child's diet (and it is better to exclude them from the menu altogether).
To make a correct diagnosis, the doctor needs:
- Producecareful visual inspection of lesions.
- Write out a referral for testing.
- Find out if there are people in the family with allergies.
It is important to understand that a child's body is much weaker than that of an adult. Therefore, therapy should be as gentle as possible so as not to aggravate the problem and not harm he alth.
Not everyone knows how to treat atopic march. Therapy of this pathology must necessarily include:
- Change in diet - it is better to completely exclude highly allergenic foods from the menu.
- Desensitization - elimination of the body's sensitivity to allergens.
- Taking antihistamines.
- Vitamin-mineral complexes - are selected exclusively individually for each patient, since there is a danger of provoking an exacerbation of the disease.
- Immunomodulators - used to strengthen the immune system and restore the body.
- Ointment containing hormones - are prescribed for severe forms of the course of the disease, non-hormonal drugs are used in the early stages.
- Antiviral, antifungal, and antibiotics are used when there is a secondary infection.
- Physiotherapy recommended.
Properly chosen treatment and strict adherence to doctor's recommendations increase the chance to overcome atopic march in children and adults. So take care of your he alth very carefully.
