Amaç: Bu çalışmada, yaşları 1 ay3 yaş arasında olup en az üç kez hışıltı atağı geçirmiş olan çocuklarda etiyolojinin ortaya konması ve ek olarak atopinin eşlik ettiği çoklu-tetiklenen hışıltısı olan çocuklar ile epizodik (viral) hışıltısı olan çocukların birbiriyle kıyaslanması amaçlandı. Olgular ve Yöntem: Çalışmaya ilki 1 yaş altında olmak koşulu ile en az üç hışıltı atağı geçirmiş olan toplam 170 çocuk alındı. Etiyolojiyi aydınlatmak üzere, ayrıntılı öykü ve fizik muayenenin yanı sıra, tam kan sayımı, periferik kanda eozinofil, serum immunglobulin düzeyleri, ter testi, PPD, akciğer grafisi, gastroösefageal reflü sintigrafisi, allerjen spesifik IgE, deri ‘prick’ testi ve gerektiği hallerde yapılan toraksın bilgisayarlı tomografi incelemesi, hastaların dosyalarından retrospektif olarak kaydedildi. Bulgular: Etiyolojik açıdan yapılan incelemeler ile 67 olgu (% 39.4) viral hışıltı atakları, 57 olgu (% 33.5) atopinin eşlik ettiği çoklu-tetiklenen hışıltı atakları, 29 olgu (% 17.1) gastroösefageal reflü, 5 olgu (% 2.9) bronkopulmoner displazi tanısı aldı. Viral hışıltılı çocuklarda ilk atak yaşının atopinin eşlik ettiği çoklu-tetiklenen hışıltısı olanlara kıyasla daha düşük olduğu (p=0.013) ve evde nemin daha çok ifade edildiği (p=0.012) belirlendi. Maternal astım ve ailede atopi öyküsüne atopinin eşlik ettiği çoklu-tetiklenen hışıltısı olan gurupta çok daha sık rastlanırken (sırasıyla p=0.006 ve p<0.001), total IgE ve periferik kanda eozinofil yüzdesi de bu gurupta viral hışıltısı olanlara kıyasla anlamlı derecede yüksek bulundu (p<0.001, her ikisi için). Sonuç: Hayatın ilk üç yılında tekrarlayan hışıltısı olan çocuklarda etiyolojiyi ortaya çıkarmak, erken tedavi ve prognoz açısından oldukça önemlidir. Özellikle atopinin eşlik ettiği çoklu-tetiklenen hışıltılı çocuklarda erken tanı ve tedavi, bronşlardaki geri dönüşümsüz değişiklikleri büyük oranda önleyecektir.
Aim: In this study, we aimed to investigate the etiology in children aged between 1 month to 3 years who had suffered at least three wheezing episodes; additionally, to compare the children having multiple-trigger wheeze accompanied with atopy with children having episodic (viral) wheeze. Patients and Methods: This study included 170 patients who had at least three wheezing episodes on condition that the first episode before the age one. To clarify the etiology of wheezing episodes, in addition to a detailed history and physical examination, complete blood count, blood eosinophils, serum immunoglobulin levels, sweat chloride test, PPD skin testing, lung X-ray, scintigraphy for gastroesophageal reflux, allergen spesific IgE, allergen skin prick tests and, examination of thorax CT which was performed when required were all recorded from the hospital files of patients retrospectively.Results: With studies regarding etiology, 67 patients (39.4 %) were diagnosed as viral wheeze, 57 patients (33.5 %) multiple-trigger wheeze accompanied with atopy, 29 patients (17.1 %) gastroesophageal reflux disease and 5 patients (2.9 %) bronchopulmonary dysplasia. The age of children with viral wheeze at the first episode was younger (p=0.013) and they had more dampness in their homes than those of children with multiple-trigger wheeze accompanied with atopy (p= 0.012). The rate of maternal asthma and family history of atopy (p=0.006 and p<0.001, respectively), as well as total IgE levels and blood eosinophils (p<0.001, for both) were found significantly higher in children with multiple-trigger wheeze accompanied with atopy in comparison to children with viral wheeze.Conclusion: To explore the etiology in children having wheezing episodes in the first three years of life is important for early treatment and prognosis. Early diagnosis and intervention of patients with multiple-trigger wheeze accompanied with atopy will prevent irreversible changes in the airway
Other ID | JA28BJ52FR |
---|---|
Journal Section | Research Article |
Authors | |
Publication Date | December 1, 2009 |
Submission Date | December 1, 2009 |
Published in Issue | Year 2009 Volume: 3 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.