Tekrarlayan Hırıltılı Solunumu Olan Çocuklarda Atopi Sıklığı

Giriş ve Amaç: Altı yaş altında gerçek astım tanısını koymak bu yaş grubunda hırıltıyla ilişkili değişik fenotipler nedeni ile zordur. Bu çalışmanın amacı 6 yaşından küçük çocukların astım tanısı koyarken atopik durumlarını belirlemektir.Bulgular: Bu çalışma Keçiören Eğitim ve Araştırma Hastanesi Çocuk Allerji Polikliniğinde gerçekleştirildi. Çalışmaya 2 yaşından önce hırıltısı başlamış ve en az 3 kez hırıltılı solunum sıkıntısı atağı geçiren toplam 236 çocuk (150 erkek,% 63.6) alındı. Ortalama yaşları 39.7±20.1 aylık olarak bulundu. Tekrarlayan hırıltılı solunumla gelen bu çocuklar geçici hırıltı, atopik hırıltı ve Nonatopik hırıltı olarak sınıflandırılmıştır.Sonuçlar: Bu çalışmada 3 farklı hırıltı fenotipi belirlendi. Nonatopic viral hırıltı (n:112, %47.5), Atopik hırıltı (Astım) (n:94, %39.8) ve Geçici hırıltı (n:30, %12.7). Astımlı çocuklar arasında (n:94), 69 hasta (%73.4) atopik olarak bulundu. Tüm çocuklar arasında IgE değeri >100 IU/ml olan 39 hasta (%83) astım tanısı alırken, (p<0.001) IgE değeri <100 IU/ml olan 55 (% 29.1) hasta astım tanısı aldı (p<0.001).Sonuç: Bu çalışma okul öncesi astımlı çocukların 3/4’ünün atopik olduğunu ve bu çocukların %83 ünde IgE değerinin >100 IU/ml üzerinde olduğu gösterilmiştir. Deri testi ve IgE gerçek astımlıları tanımlamamız bu yaş grubunda steroid tedavisine cevap verecekleri ayırt etmemize yardımcı olabilir

Anahtar Kelimeler:

Hırıltı, atopi, çocuk, total IgE

ATOPY FREQUENCY IN CHILDREN WITH RECURRENT WHEEZING

Background: It is difficult to diagnose real asthma in children under 6 years of age because of different phenotypes of wheezing related disorders in this age group. Objective: The purpose of this study is to determine atopic status of children under 6 years of age in diagnosing real asthma.Methods: This study was performed in the outpatient clinic of Pediatric Allergy Department in Keçiören Education and Training Hospital. Children who had first wheezing episode before 2 years old and at least 3 episodes of wheezing were included in this study. A total of 236 children (150 boys, 63.6%) with a mean age of 39.7±20.1 months were included in the study. The children admitted with recurrent wheezing were classified as transient wheezing, atopic wheezing and nonatopic wheezing.Results: Three different wheezing phenotypes were identified in this study: nonatopic viral wheezing (n:112, 47.5%), atopic wheezing (asthma) (n:94, 39.8%) and transient infantile wheezing (n:30, 12.7%). The ratio of atopic children was 73.4% (n:69) among asthmatic 94 children. The ratio of children whose IgE levels were >100 IU/ml and diagnosed asthma was 83% (n:39), among all of the children (p<0.001). However, there were 55 children (29.1%) whose Ig E levels were <100 IU/ml and diagnosed asthma (p<0.001). Conclusion: This study demonstrated that ¾ of preschool asthmatic children had atopy and 83% of these children had IgE levels >100 IU/ml. Skin prick test and IgE should be helpful to identify real asthmatics who will respond to steroid treatment in this age group

Keywords:

Wheezing, atopy, children, total IgE,

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