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Pediatrik Allerjide Konsültasyonlar

Year 2011, Volume: 5 Issue: 4, 202 - 207, 01.04.2011

Abstract

Giriş ve Amaç: Tanı konulmasında zorluk yaşanan hastalarda konsültasyonlar, doktorlar arasında doğru tanı ve uygun tedavi için gerekli bir gereç olmaya devam etmektedir. Materyal-Method: 1 Eylül 2008 ve 31 Ağustos 2009 tarihleri arasında Pediatrik Allerji Kliniğimize konsülte edilen toplam 1019 hastanın hastane kayıtları retrospektif olarak incelendi. Bulgular: Yaşları 3 ay ile 18 yaş arasında değişen toplam 1019 hastanın konsültasyon bilgileri gözden geçirildi. Bunların 635’i (%62.3) erkekti. Konsültasyonların %71.8’i pediatri kliniklerinden, %15’i yan dal kliniklerinden, %6.4’i dermatoloji polikliniğinden, %3.8’i acil polikliniğinden ve %3’ü cerrahi kliniğinden istenmişti. Konsültasyonların en sık istenme nedenleri ise %22.3’ünde kronik öksürük, %17.6 astım, %11.3 hışıltılı infant, %10 ürtiker/anjioödem, %8.6 atopik egzema, %6.9 allerjik rinit ve %6.5 döküntü/kaşıntı idi. Kliniğimizde konulan allerjik tanılar ise astım %31.8, rinit %15.4, hışıltılı infant %12, ürtiker/anjioödem %11.7, atopik egzema %9.9 ve ilaç reaksiyonu %4.3 idi. Hastanın hastaneye ilk başvurusu ile konsültasyon istenme süresi 2 dakika ile 15 gün arasında değişmekte olup ortalama 4 saatti. Konsültasyonların cevaplanma süresi ise 1 dakika ile 2 gün arasında değişiyordu (ortalama 55 dakika). Sonuç: Konsültasyonlar yanlış tanı konulmasının önlenmesi, tanı doğruluğunun pekiştirilmesi ve hastalığın uygun şekilde yönetilmesi için önemlidir. Bu sebeple, bizim bu çalışmada pediatrik tecrübelerimiz hakkında verdiğimiz bilgilerin hem allerjistler hem de konsültan hekimler için değerli ve yararlı olacağını umuyoruz.

References

  • Dietrich JJ, Quinn JM, England RW. Reasons for outpatient consulta- tion in allergy/immunology. Allergy Asthma Proc 2009;30(1):69-74.
  • Quinn JM. Pediatric inpatient consultation of allergy/immunology. Pediatric inpatient consultation of allergy/immunology. Pediatr Asthma Allergy Immunol 2000;14(4):293-9.
  • England RW, Ho TC, Napoli DC, Quinn JM. Inpatient consulta- tion of allergy/immunology in a tertiary care setting. Ann Allergy Asthma Immunol 2003;90(4):393-7.
  • Robinson PD. Van Asperen P. Asthma in childhood. Pediatr Clin North Am 2009;56(1):191-226.
  • Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America Survey. J Allergy Clin Immunol 2009;124(3 Suppl):43-70.
  • Yorgancioglu A, Kalayci O, Kalyoncu AF, Khaltaev N, Bousquet J. Allergic rhinitis and its impact on asthma update (ARIA 2008) [The Turkish perspective]. Tuberk Toraks 2008; 56(2):224-31.
  • Bieber T. Atopic dermatitis. N Engl J Med 2008;358(14):1483-94.
  • Ker J, Hartert TV. The atopic march: what’s the evidence? Ann Al- lergy Asthma Immunol 2009;103(4):282-9.
  • Sampson HA and Burks AW. Adverse reactions to foods. In: Ad- kinson Jr NF, Bochner BS, Busse WW, Holgate St, Lemanske Jr RF, and Simons FER eds. Middleton’s Allergy Principles & Prac- tice. 7th ed. USA: Elsevier Inc 2009:1139-67.
  • Orhan F, Karakas T, Cakir M, Aksoy A, Baki A, Gedik Y. Preva- lence of immunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy 2009;39(7):1027-35.

CONSULTATIONS IN PEDIATRIC ALLERGY

Year 2011, Volume: 5 Issue: 4, 202 - 207, 01.04.2011

Abstract

Aim: Consultation among physicians remains an essential component of accurate diagnosis and appropriate treatment of a patient having diagnostic problems. Methods: A retrospective review of hospital records was conducted in a total of 1019 patients consulted at pediatric allergy clinic between September 1, 2008 and August 31, 2009. Results: A total of 1019 allergy consults whose ages ranged from 3 months to 18 years old were reviewed. Among these consultations; 635 (62.3%) were boys. Consultations were requested by clinics of pediatrics (71.8%), subbranch clinics (15%), dermatology (6.4%), emergency service (3.8%), and surgery (3%). The most common reasons for consultation included chronic cough (22.3%), asthma (17.6%), wheezing (11.3%), urticaria/angioedema (10%), atopic eczema (8.6%), allergic rhinitis (6.9%), and eruption/itching (6.5%). The diagnosis of allergic disorders in our clinic were asthma (31.8%), rhinitis (15.4%), wheezy infant (12%), urticaria/angioedema (11.7%), atopic eczema (9.9%), and adverse drug reaction (4.3%). Elapsed time between patient’s first referral to our hospital and his/her consultation was ranged from 2 minutes to 15 days, with a mean duration of 4 hours. Response time to consultations differed from 1 minute to 2 days (mean duration: 55 minutes). Conclusions: Consultation is crucial in preventing misdiagnosis, improving the accuracy of diagnosis, and the appropriate management of diseases. Therefore, we hope the information about pediatric experience given in this study could be valuable and very useful for both the allergists as consultant and other counseling physicians

References

  • Dietrich JJ, Quinn JM, England RW. Reasons for outpatient consulta- tion in allergy/immunology. Allergy Asthma Proc 2009;30(1):69-74.
  • Quinn JM. Pediatric inpatient consultation of allergy/immunology. Pediatric inpatient consultation of allergy/immunology. Pediatr Asthma Allergy Immunol 2000;14(4):293-9.
  • England RW, Ho TC, Napoli DC, Quinn JM. Inpatient consulta- tion of allergy/immunology in a tertiary care setting. Ann Allergy Asthma Immunol 2003;90(4):393-7.
  • Robinson PD. Van Asperen P. Asthma in childhood. Pediatr Clin North Am 2009;56(1):191-226.
  • Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America Survey. J Allergy Clin Immunol 2009;124(3 Suppl):43-70.
  • Yorgancioglu A, Kalayci O, Kalyoncu AF, Khaltaev N, Bousquet J. Allergic rhinitis and its impact on asthma update (ARIA 2008) [The Turkish perspective]. Tuberk Toraks 2008; 56(2):224-31.
  • Bieber T. Atopic dermatitis. N Engl J Med 2008;358(14):1483-94.
  • Ker J, Hartert TV. The atopic march: what’s the evidence? Ann Al- lergy Asthma Immunol 2009;103(4):282-9.
  • Sampson HA and Burks AW. Adverse reactions to foods. In: Ad- kinson Jr NF, Bochner BS, Busse WW, Holgate St, Lemanske Jr RF, and Simons FER eds. Middleton’s Allergy Principles & Prac- tice. 7th ed. USA: Elsevier Inc 2009:1139-67.
  • Orhan F, Karakas T, Cakir M, Aksoy A, Baki A, Gedik Y. Preva- lence of immunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy 2009;39(7):1027-35.
There are 10 citations in total.

Details

Other ID JA32PJ55KN
Journal Section Research Article
Authors

Serap Özmen This is me

Emine Dibek Mısırlıoğlu This is me

Tayfur Giniş This is me

Miraç Yıldırım This is me

Mahmut Doğru This is me

Handan Duman This is me

İlknur Bostancı This is me

Publication Date April 1, 2011
Submission Date April 1, 2011
Published in Issue Year 2011 Volume: 5 Issue: 4

Cite

Vancouver Özmen S, Mısırlıoğlu ED, Giniş T, Yıldırım M, Doğru M, Duman H, Bostancı İ. CONSULTATIONS IN PEDIATRIC ALLERGY. Türkiye Çocuk Hast Derg. 2011;5(4):202-7.


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