2018

Clinical Characteristics of Fungal Sensitization in Children with Allergic Respiratory Diseases

Amaç: Çalışmanın amacı polikliniğimize başvuran okul çağındaki allerjik solunum yolu hastalıkları olan çocuklarda küf mantarı duyarlılığının sıklığının araştırılması ve duyarlılığın hastalığın ağırlığındaki öneminin tespit edilmesidir.Gereç ve Yöntemler: Küf mantarı sezonunda allerjik semptomları olan çocuklardan polikliniğimize Ocak 2014-Ağustos 2015 tarihleri arasında başvuranlar allerjik solunum yolu hastalıkları açısından değerlendirildi. Küf mantarı ve ticari standardize edilmiş aeroallerjenler ile deri prik testi yapıldı. Astımlı çocuklara spirometri uygulandı. Serum total immünoglobulin E (IgE) düzeyine bakıldı ve spesifik IgE (sIgE) düzeyleri ölçüldü. Bulgular: Çalışmaya 112 çocuk alındı. Küf mantarı duyarlılığının sıklığı %6,4 bulundu. Alternaria alterna hem mono hem de polisensitize çocuklarda en sık küf mantarı allerjeni idi (sırasıyla, p=0,002, p=0,004). Alternaria alterna duyarlılığı persistan allerjik riniti olanlarda intermittan olanlara göre belirgin yüksekti (p=0,002). Hafif astımı olan hastalar daha çok monosensitize (p=0,003) iken, ağır astımı olanlar polisensitize (p=0,007) idi. Polisensitize olanlarda Alternaria alterna ve Cladosporium spp. birlikteliği diğer küf mantarlarına göre daha sıktı (p

Duyarlılığının Klinik Özellikleri Allerjik Solunum Yolu Hastalıkları Olan Çocuklarda Küf Mantarı

Objective: The aim of the study was to evaluate the prevelance of fungal sensitization among school-aged children with allergic respiratory diseases who attended our outpatient clinic and to evaluate its clinical impact on disease severity. Materials and Methods: Children with allergic symptoms during mould season, who attended our outpatient clinic between January 2014 and August 2015, were evaluated for allergic respiratory diseases. Skin prick testing with fungal and other commercial standardized solutions of aeroallergens was performed in all children. Spirometry was performed in children with asthma. Serum total immunoglobulin E(IgE) and aeroallergen specific IgE (sIgE) levels were measured. Results: A total of 112 children were included in the study. The prevelance of fungal sensitization was 6.4%. Alternaria alterna was the most common fungal allergen in both mono and polysensitized groups (p=0.002, p=0.004, respectively). Alternaria alterna sensitization was significantly higher in patients with persistent allergic rhinitis compared to those with intermittant allergic rhinitis (p=0.002). The patients with mild asthma were mostly monosensitized (p=0.003), but cases with severe asthma (SA) were polysensitized (p=0.007). In polysensitized cases, Alternaria alterna and Cladosporium spp. coexistance was the most common combination compared to other fungal combinations (p<0.001). The sensitivity rate of sIgE was found to be 88%. In spirometric analysis, forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity values were lower in polysensitized children with asthma and in children with asthma coexisting allergic rhinitis compared to children with allergic rhinitis only (p=0.004, p=0.001, respectively). Conclusion: The most common fungal allergen was Alternaria alterna in children with mono or polysensitization. Polysensitization with fungal allergens was closely associated with SA and lower spirometric parameters.

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