Çocukluk Çağında Allerjik Rinit

Yıl 2011, Cilt: 9 Sayı: 1, 105 - 112, 01.06.2011

Arzu Babayiğit Hocaoğlu , Özkan Karaman

Öz

İmmunglobulin E aracılıklı bir hastalık olan allerjik rinit, çocukluk çağının en sıkrastlanan kronik allerjik hastalığıdır. Bu hastalık, hapşırık, burun akıntısı, damak vegözlerde kaşıntı ve konjesyon ile karakterizedir ve çocukların sağlığını önemliölçüde etkileyebilmektedir. Rahatsızlık verici semptomlara neden olabilmekte,yaşam kalitesini etkileyebilmekte ve astım gibi komorbiditelerin oluşumuna eğilimsağlayabilmektedir. Etiyolojik tanı, yüksek sensitivite ve spesifiteye sahip ve küçükçocuklara da kolayca uygulanabilen deri prik testleri sonuçlarına dayanılarakbelirlenebilmektedir. Tedavi öncelikle korunma önlemleri ve gerekli görülürse farmakoterapi ve immunoterapiyi içermektedir. Farmakoterapi genellikle antihistaminikler ve/veya nazal kortikosteroidleri kapsamaktadır, ancak lökotrienreseptör antagonistleri de allerjik rinit semptomlarının tedavisinde etkilibulunmuşlardır. Bu makalede, çocukluk çağında allerjik rinit bulguları, tanısı vetedavisi tartışılmıştır

Anahtar Kelimeler

Allerjik rinit, çocukluk çağı, tanı, tedavi

Allergic Rhinitis in Childhood

Öz

Allergic rhinitis, an immunoglobulin E mediated disease, is the most commonchronic allergic childhood disease. The disease is characterized by nasal sneezing, rhinorrhea, palate and eye itchiness, and congestion and it can significantly impact children’s health. It causes uncomfortable symptoms, impairsquality of life and can predispose to the development of comorbidities such asasthma. Etiological diagnosis is based on cutaneous prick tests, which have ahigh sensitivity and specificity rate and which can be easily applied to young children. Treatment initially involves avoidance measures and, when necessary,pharmacotherapy or immunotherapy. Pharmacotherapy generally involves antihistamines and/or nasal corticosteroids, but leukotriene antagonists have alsodemonstrated effectiveness in treating allergic rhinitis symptoms. In this article,the symptoms, diagnosis and treatment of allergic rhinitis in childhood are discussed

Anahtar Kelimeler

Allergic rhinitis, childhood, diagnosis, treatment

Kaynakça

• 1. Van Cauwenberge P, Bachert C, Passalacqua G, Bousquet J, Canonica GW, Durham SR et al. Consensus statement on the treatment of allergic rhinitis. European Academy of Allergology and Clinical Immunology. Allergy 2000;55:116-34.
• 2. Bousquet J, Van Cauwenberge P, Khaltaev N; Aria Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001;108:147-334.
• 3. Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108:2-8.
• 4. Strachan D, Sibbald B, Weiland S, Aït-Khaled N, Anabwani G, Anderson HR et al. Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC). Pediatr Allergy Immunol 1997;8:161-76.
• 5. Björkstén B, Clayton T, Ellwood P, Stewart A, Strachan D. ISAAC Phase III Study Group. Worldwide time trends for symptoms of rhinitis and conjunctivitis: Phase III of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol 2008;19:110-24.
• 6. Kurt E, Metintas S, Basyigit I, Bulut I, Coskun E, Dabak S et al. PARFAIT Study of the Turkish Thoracic Society Asthma and Allergy Working Group. Prevalence and Risk Factors of Allergies in Turkey (PARFAIT): results of a multicentre cross-sectional study in adults. Eur Respir J 2009;33:724-33.
• 7. Civelek E, Cakir B, Boz AB, Yuksel H, Orhan F, Uner A et al. Extent and burden of allergic diseases in elementary schoolchildren: a national multicenter study. J Investig Allergol Clin Immunol 2010;20:280-8.
• 8. Tamay Z, Akcay A, Ones U, Guler N, Kilic G, Zencir M. Prevalence and risk factors for allergic rhinitis in primary school children. Int J Pediatr Otorhinolaryngol 2007;71: 463-71.
• 9. Karaman O, Turgut CS, Uzuner N, Olmez D, Babayigit A, Kose S et al. The determination of asthma, rhinitis, eczema, and atopy prevalence in 9- to 11-year-old children in the city of Izmir. Allergy Asthma Proc 2006;27:319-24.
• 10. Yuksel H, Dinc G, Sakar A, Yilmaz O, Yorgancioglu A, Celik P et al. Prevalence and comorbidity of allergic eczema, rhinitis, and asthma in a city in western Turkey. J Investig Allergol Clin Immunol 2008;18:31-5.
• 11. Gentile DA, Shapiro GG, Skoner DP. Allergic Rhinitis. In: Leung DYM, Sampson HA, Geha RS, Szefler, SJ editors. Pediatric Allergy: Principles and practice. Mosby USA 2003: 287-97.
• 12. Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics 1994;94:895-901.
• 13. Aberg N, Engstrom I. Natural history of allergic diseases in children. Acta Paediatr Scand 1990;79:206-11.
• 14. Blaiss MS. Allergic Rhinitis in Schoolchildren Consensus Group. Allergic rhinitis and impairment issues in school children: a consensus report. Curr Med Res Opin 2004;20:1937-52.
• 15. Boner AL, Martinati LC. Diagnosis of asthma in children and adolescants. Eur Respir Rev 1997;7:3-7.
• 16. Carr WW. Improvements in skin-testing technique. Allergy Asthma Proc 2006;27:100-3.
• 17. Quillen DM, Feller DB. Diagnosing Rhinitis: Allergic vs. Nonallergic Am Fam Physician 2006; 73:9 1583-90.
• 18. Ricketti AJ. Allergic Rhinitis, in Allergic Diseases Diagnosis and Management eds: Patterson R, Grammer LC, Greenberger PA. Lippincott Williams and Wilkins Comp Philadelphia 2002,159-182.
• 19. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;86:8-160.
• 20. Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1-receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ 1998;317:1624-9.
• 21. Rodrigo GJ, Yanez A. The role of antileukotriene therapy in seasonal allergic rhinitis: a systematic review of randomized trials. Ann Allergy Asthma Immunol 2006;96:779-86.
• 22. Cingi C, Ozlugedik S. Effects of montelukast on quality of life in patients with persistent allergic rhinitis. Otolaryngol Head Neck Surg 2010;142:654-8.
• 23. Cingi C, Gunhan K, Gage-White L, Unlu H. Efficacy of leukotriene antagonists as concomitant therapy in allergic rhinitis. Laryngoscope 2010;120:1718-23.
• 24. Passalacqua G, Durham SR. Global Allergy and Asthma European Network. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol 2007;119: 881-91.
• 25. Norman PS. Immunotherapy: 1999-2004. J Allergy Clin Immunol 2004;113:1013-23.
• 26. Inal A, Altintas DU, Yilmaz M, Karakoc GB, Kendirli SG, Sertdemir Y. Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite. J Investig Allergol Clin Immunol 2007;17:85-91.
• 27. American Academy of Allergy, Asthma and Immunology. American College of Allergy, Asthma and Immunology. Allergen immunotherapy: A practice parameter. Ann Allergy Asthma Immunol 2003;90:1-40.