VALIDITY OF THE MANIFESTATION AGE AND FEATURES OF THE SKIN CLINICAL SYMPTOMS FOR DIFFERENTIAL DIAGNOSTICS OF THE FOOD HYPERSENSITIVITY IN CHILDREN

Pakholchuk O. P.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Symptoms of the food hypersensitivity on the skin in children can have as immune as nonimmune mechanisms. Taking to consideration classical cytokines of the allergic inflammation independently from the type of the allergic reaction, it can be supposed that in case of nonimmune processes and absence of histamine liberation, clinical symptoms will have differences. Further study of the features of the food hypersensitivity clinical manifestation will give background to the optimization of the diagnostics and treatment approaches. Aim of the studywas to evaluate validity of the manifestation age and features of the skin clinical symptoms for differential diagnostics of the food hypersensitivity in children in compare with results of the standard test for allergy diagnostics. Object and methods.424 patients aged 26,3[12,1;54,2] months were included in the study. Diagnosis of food allergy was made with EAACI criterions in case of FA reproducible occurrence on exposure to the suspected food. Patients with food anaphylaxis were not included. Skin-prick tests (SPT), serum specific IgE level and oral challenge test (OCT) with common food allergens were used for hypersensitivity proof. Oral challenge test was performed in accordance with the EAACI recommendations and local Ethical requirements. Open oral provocation was used for infants up to 1 y. o. Double blind placebo controlled oral challenge was provided in others. All statistical analyses were performed in commercial software Statistica (Statsoft, USA). All continuous variables were tested for a normal distribution using the Shapiro-Wilk’s W test. Continuous variables were presented as median inter-quartile range because of the non-normal distribution. Linear association between two variables was assessed with Spearman Rank order correlation. Results.Symptoms of the food hypersensitivity on the skin in children of early age (21[6,3;42,9] months) have tendency to the generalization and location on the face ((p<0,05). FH manifestation age is prognostic factor. Debut of the symptoms before 1 year of age correlates with positive skin prick-test, oral challenge test, which reflect immune mechanisms. Severity of the itching correlated with positive results of the skin prick-test (r=0,45, p<0,05). Conclusions. Skin clinical symptoms of the food hypersensitivity in children vary depending on the age group, age of the manifestation. Debut of the FH skin symptoms before 1 year of age and severe itching correlates with positive results of the standard tests for allergy diagnostics. This fact can be used for differentiation of FH phenotypes.

children, food hypersensitivity, manifestation, itching, prick-test, challenge test

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 148-152 pages, index UDK 616.5-021.5-036-039.5-079.4

10.29254/2077-4214-2018-1-1-142-148-152