For the diagnosis, treatment and follow-up of allergic diseases that can be seen in childhood, the opinions of the experts who have completed their specialty education in the field of child allergy are of great importance. These diseases are not just a discomfort of an organ system. For this reason, in order to evaluate the diseases as a whole, it is necessary to know the history of the disease, to analyze the possible conditions affecting the clinical course, to use the correct and economical diagnostic methods, and to make the most accurate treatment planning. Thanks to all this, not only day-saving solutions, but long-term solutions can be produced.
In the diagnosis of allergic diseases, determining which allergens cause the disease is very important. For this purpose, allergen skin tests with specific IgE that can be measured in serum are laboratory methods used for diagnosis. The interpretation of these tests must be done by a child allergist, taking into account the patient’s physical examination findings, clinical course and follow-up. Evaluation of only test results may not be sufficient.
Diseases that may occur:
- Asthma: It is the most common chronic respiratory illness in childhood. Recurrent cough progresses with wheezing and shortness of breath. In particular, allergen sensitivity is the most important stimulus in the development of asthma. In addition to allergens, factors such as respiratory infections, environmental air pollution, cigarette smoke make it difficult to control asthma and tighten attacks. In the diagnosis and treatment of asthma, as well as tests for the detection of responsible allergen, pulmonary function tests are applied in certain age groups in childhood. Long-term treatment of the patient is planned according to the test results.
- Allergic rhinitis (hay fever/spring fever): It is one of the most common childhood diseases which can be seen together with nasal congestion, runny nose and itching, sneezing, watery eyes. As it can be observed all year round, it can increase seasonally especially in spring. Quality of life, sleep patterns and school success of children with allergic rhinitis can be negatively affected. In allergic rhinitis disease; Growth in adenoids, fluid accumulation in the middle ear, development of otitis media, development of sinusitis can be seen frequently. Allergic rhinitis is an important health problem that should not be ignored.
- Atopic dermatitis (Eczema): Atopic dermatitis, also called infantile eczema, is characterized by dry skin, cheeks, arms and legs, eczematous skin lesions and itching especially in infancy. Food sensitivities cause exacerbation of atopic dermatitis lesions, especially during the transition to supplementary foods. Children with atopic dermatitis should definitely be followed up for the development of other allergic diseases at a later age.
- Food allergies: Food allergies are most often observed during infancy, when supplementary foods are started. Although food sensitivities may differ depending on social dietary habits and age, cow milk, eggs, nuts, cereals and fish are the most common causes of food allergies.
- Urticaria: These are skin findings characterized by raised, itchy skin lesions on the upper layers of the skin after contact with the allergen. It is also defined as hives among the people. Urticaria is sometimes accompanied by swelling characterized by edema of the lower layers of the skin, called angioedema. In addition to exposure to allergens from acute urticaria attacks, infections also play an important role.
Anaphylaxis: It is a common allergic reaction type in which more than one system is affected. In some tables it may be life-threatening and prompt treatment is required. Anaphylaxis most often occurs after contact with food allergens, after insect bites and drug allergies. Necessary measures should be taken to prevent the formation of anaphylaxis, parents’ education and emergency treatment planning should be made.
The antibodies in our body fight against the germs and bacteria that enter the body. But these antibodies also prepare for battle when they see some harmless substances as harmful. The war between these substances and the desire of the immune system to destroy these harmless substances is called “allergy”.
WHAT ARE THE SYMPTOMS OF ALLERGY?
Allergy symptoms differ according to allergy types. Runny nose, itching, sneezing, stiff throat, cough, nasal discharge and nasal congestion are among the common symptoms. Some allergens, such as pollen and house dust, affect the lower respiratory tract, causing asthma, cough, shortness of breath, and the upper respiratory tract, leading to symptoms such as the runny nose, sneezing. Allergic people have more meat growths, skin reactions, asthma and sinusitis than in normal people. In addition, factors such as stress, intense working environment, increased air pollution, and additives added to foods lead to increased frequency of allergies.
The most common allergens are;
o Grass and tree pollen
o Pets’ skin or feathers
o Various foods (milk, eggs, soy, seafood, fruits and nuts)
o House and dust mites
o Mushroom or mold spores
o bee stings
o Some medicines
o Chemical resins, rubber, nickel
o Rubber, rubber-made materials
o Necklace, jewellery such as earrings
- Allergic cold or allergic rhinitis
- Eye fever or allergic conjunctivitis
- Allergic asthma
- Urticaria (Hives)
- Drug allergy
- Insect allergy
- Bee allergy
- Food allergy
- Atopic Dermatitis
WHAT ARE ALLERGY TESTS?
Allergens can be determined by skin tests and blood tests. It is determined within 20 minutes by skin test and within 24 – 48 hours by blood analysis.
1 – Prick Test: 20 – 30 types of allergens can be determined. The patient’s skin is scratched. Allergy-causing substances are prepared as solutions and left on the scratched skin for approximately 30 minutes. The substance that is dropped in places with a rash is considered an allergen. It should be noted here that some antidepressant drugs, flu medications and cough medications can affect the result of the test. Therefore, if there is a drug used before taking this allergy test, the doctor should be told.
2 – Patch Test: It is a method used in the detection of allergens that cause eczema. By pouring chemicals on tape, the tape is attached to the patient’s back and waited for 2 days. The tape is removed after 2 days. Allergens of the patient are detected in any substance in places with the rash.
3 – Blood Test (IgE antibody): It is a method used to measure the rate of IgE antibody in the blood. In allergic patients, this rate is 10 times higher than in normal patients.