Tekrarlayan Hırıltılı Solunumu Olan Çocuklarda Atopi Sıklığı

Yıl 2009, Cilt: 3 Sayı: 4, 10 - 15, 01.04.2009

Cem Hasan Razi Koray Harmancı Gonca Yılmaz Rahime Renda Okan Akın

Öz

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

Öz

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

Anahtar Kelimeler

Wheezing, atopy, children, total IgE

Kaynakça

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