Hışıltılı Çocukların Genel Özellikleri

Yıl 2020, , 69 - 72, 15.06.2020

Ezgi Ulusoy , Raziye Burcu Güven Bilgin Cem Murat Bal Remziye Tanaç , Figen Gulen , Esen Demir

https://doi.org/10.16948/zktipb.528048

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

Öz

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.

Anahtar Kelimeler

Asthma, atopy

Kaynakça

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