Hışıltılı Çocukların Genel Özellikleri

Öz

Amaç: Tekrarlayan hışıltı okul öncesi çocuklarda önemli bir klinik sorundur. Çocukların yaklaşık üçte biri 3 yaşından önce en az bir hışıltı atağı geçirmektedir. Bu çalışmada departmanımızda tekrarlayan hışıltı nedeniyle izlenen hastaların genel özelliklerinin tanımlanması amaçlanmıştır.

Gereç ve Yöntemler: Alerji polikliniğine yılda 3 veya daha fazla hışıltı yakınması ile başvuran 691 hasta retrospektif olarak değerlendirilmiştir. Hastaların demografik, klinik ve laboratuvar özellikleri anket formları doldurularak tespit edilmiştir.

Bulgular: Tekrarlayan hışıltısı olan 215(%31) kız, 476(% 69) erkek,  691 hasta retrospektif olarak değerlendirildi. Semptomlar hastaların %52,5’unda 0-1 yaş, %76.4’ünde 0-3 yaşta, %9,9 hastada 6 yaşından sonra başlamıştı. Ataklar sıklıkla kış mevsiminde(%54,4) olup, %19 oranında ataklar arasında semptom mevcuttu. Hospitalizasyon  oranı %49 (ort. 1.19±0.86) olup, <1 yaşta en sıktı(%71). Ailede akrabalık, atopi ve astım oranları sırasıyla % 11.2, %42,2 ve %22,4 olup  hastaların %54,8’i ailenin ilk çocuğuydu.

Hastaların %3,9’unda atopik dermatit , %17,9’unda alerjik rinit öyküsü vardı. Eozinofili %32,4,  IgE: 335±839 kU/L,  spIgE ile %40,8 aeroalerjen ,%30,6 gıda alerjen duyarlılığı bulunmuştur. Hastaların %23,1’inde immun bozukluk saptanmıştır. Deri prick testi(DPT) %31 hastada pozitif  olup, dermatofagoid(%46), ot polen(%51), zeytin(%24), kedi(%23,7), alternaria(%13,8) en sık duyarlı olunan alerjenlerdi.

Hastaların %34.9’unda hışıltı ataklarının 6 yaşından önce gerilediği, %11,1’inde 3 yaşından sonra başladığı, %11.7’sinde ise 6 yaşından sonra başladığı görüldü. Üç yaşından önce başlayan ve 6 yaşından sonra devam eden grubun ise bir kısmının atopik olduğu bir kısmının ise non-atopik olduğu görüldü.

Sonuç: Yineleyen hışıltı, çoğunlukla 0-3 yaşta başlayan, %34.9 geçici, atopinin  en önemli risk faktörü olduğu bir klinik sorundur.

Anahtar Kelimeler

• Astım,atopi

General Features of Wheezy Children

Abstract

Objective: Recurrent wheezing is an important clinic problem among preschool children. Nearly one third of the children have at least one wheeze episode before three years of age. The aim of this study is to identifiy general features of chidren with recurrent wheezing.

Materials and Methods: Six hundred and ninety-one children attemted to pediatric allergy clinic for recurrent wheezing more than 3 attacks per year, were evaluated retrospectively. Questionary forms were filled for demographic, clinic and laboratory features.

Results: Two hundred and fifteen(31%) girls, 476(69%) boys, 691 children were evaluated retrospectively. Onset of symptoms  were 0-1 year in 52.2% patients, 0-3 years in 76.4% patients, after 6 years in 9.9% patients.  Most of the attacks were usually in winter (54.4%). Nineteen percent of patients had symptoms between attacks. Forty-nine percent of our patients were hospitalized, mostly before 1 year of age. Consangunity was 11.2% whereas atopy and asthma was seen respectively  42.2%, 22.4%  in family members. Most patients were the first child of the family(54.8%).

Atopic dermatitis and allergic rhinitis were seen in 3.9% and 17.9% of patients.  Eosinophilia was 32.4% positive, mean serum total IgE levels were 335±839 kU/L, aero-alergen sensitivity with spIgE was 40.8% and food allergen sensitivity was 30.6%. Immunodeficiency was found 23.1% . Skin prick tests were 31% positive and grasses(51%), dermatofagoides(46%), olea(24%), cat(23.7%) and alterinaria(13.8%) were the most common allergens.

In these patients 34.9% of wheeze attacks were resolved before 6 years, 11.1% started after 3 years and 11.7% started after 6 years. Some of the patients whose wheeze attacks started before 3 yeras and persisted after 3 years, were found atopic  and some were non-atopic.

Conclusion: Recurrent wheezing is a clinic problem in which atopy is an important risk factor, usually starting before 3 years of age and 34,9% is transient.

Keywords

• Asthma,atopy

Kaynakça

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