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Hışıltılı Çocukların Genel Özellikleri

Yıl 2020, Cilt: 51 Sayı: 2, 69 - 72, 15.06.2020
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.

Kaynakça

  • Referans1. de Benedictis FM, Bush A. Infantile wheeze: rethinking dogma. Arch Dis Child. 2016 Oct 4. BMJ. 2014;348:g15.
  • Referans2. Bush A, Grigg J, Saglani S. Managing wheeze in preschool children. BMJ. 2014;348:g15.
  • Referans3. Ren CL, Esther CR Jr, Debley JS, Sockrider M, Yilmaz O, Amin N, et al. Official American Thoracic Society Clinical Practice Guidelines: Diagnostic Evaluation of Infants with Recurrent or Persistent Wheezing. Am J Respir Crit Care Med. 2016 ;194(3):356-73.
  • Referans4. Boyer D, Barsky E, Papantonakis CM, Pittman J, Ren CL, Esther CR Jr, Wilson KC, Thomson CC. Diagnostic Evaluation of Infants with Recurrent or Persistent Wheezing. Ann Am Thorac Soc. 2016 ;13(11):2057-2059.
  • Referans5. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ; Group Health Medical Associates. Asthma and wheezing in the first six years of life. N Engl J Med 1995;332:133–138.
  • Referans 6.Devulapalli CS, Carlsen KC, Haland G, Munthe-Kaas MC, Pettersen M, Mowinckel P, Carlsen KH. Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax 2008;63: 8–13.
  • Referans7. Bacharier LB, Phillips BR, Bloomberg GR, Zeiger RS, Paul IM, Krawiec M et al. Severe intermittent wheezing in preschool children: a distinct phenotype. J Allergy Clin Immunol. 2007 ;119(3):604-10.
  • Referans8. Tenero L, Piazza M, Piacentini G. Recurrent wheezing in children. Transl Pediatr. 2016 ;5(1):31-6.
  • Referans9. Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics. 2002 ;110(2 Pt 1):315-22.
  • Referans10. Muglia C, Oppenheimer J. Wheezing in Infancy: An Overview of Recent Literature. Curr Allergy Asthma Rep. 2017 11;17(10):67.
  • Referans11. Henderson J1, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, Strachan DP, Shaheen SO, Sterne JA. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax. 2008 ;63(11):974-80.
  • Referans12. Savenije OE1, Granell R, Caudri D, Koppelman GH, Smit HA, Wijga A, de Jongste JC, Brunekreef B, Sterne JA, Postma DS, Henderson J, Kerkhof M. Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMA. J Allergy Clin Immunol. 2011 ;127(6):1505-12.e14.
  • Referans13. Rusconi F, Galassi C, Corbo GM, et al. Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group. Am J Respir Crit Care Med 1999.
  • Referans14. Alper Gürz A , Artıran İğde F.A, Dikici M.F , Yarış F. Birinci Basamakta Hışıltılı Çocuğa Yaklaşım. Turkısh Journal Of Famıly Medıcıne And Prımary Care 2013 ;7(2):18-25.
  • Referans15. Rajkumar V, Rajendra B, How CH, Ang SB. Wheeze in childhood: is the spacer good enough? Singapore Med J. 2014 ;55(11):558-62.
  • Referans16. de Sousa RB, Medeiros D, Sarinho E, Rizzo JÂ, Silva AR, Bianca AC.Risk factors for recurrent wheezing in infants: a case-control study. Rev Saude Publica. 2016;50:15.
  • Referans17. Singh S, Sharma BB, Sharma SK , Sabir M, Singh V; ISAAC collaborating investigators. Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution. J Asthma. 2016;53(3):238-44.
  • Referans18. den Dekker HT, Sonnenschein-van der Voort AM, de Jongste JC, Reiss IK, Hofman A, Jaddoe VW, Duijts L. Tobacco Smoke Exposure, Airway Resistance, and Asthma in School-age Children: The Generation R Study. Chest. 2015 ;148(3):607-17.
  • Referans19. O'Callaghan-Gordo C1, Bassat Q, Díez-Padrisa N, Morais L, Machevo S, Nhampossa T, Quintó L, Alonso PL, Roca A. Lower respiratory tract infections associated with rhinovirus during infancy and increased risk of wheezing during childhood. A cohort study. PLoS One. 2013 31;8(7):e69370.
  • Referans20.Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. Eur Respir J. 2015 ;45(3):774-89.
  • Referans21. Guilbert TW, Morgan WJ, Krawiec M, Lemanske RF Jr, Sorkness C, Szefler SJ et al. The Prevention of Early Asthma in Kids study: design, rationale and methods forthe Childhood Asthma Research and Education network. Control Clin Trials. 2004 ;25(3):286-310.

General Features of Wheezy Children

Yıl 2020, Cilt: 51 Sayı: 2, 69 - 72, 15.06.2020
https://doi.org/10.16948/zktipb.528048

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.

Kaynakça

  • Referans1. de Benedictis FM, Bush A. Infantile wheeze: rethinking dogma. Arch Dis Child. 2016 Oct 4. BMJ. 2014;348:g15.
  • Referans2. Bush A, Grigg J, Saglani S. Managing wheeze in preschool children. BMJ. 2014;348:g15.
  • Referans3. Ren CL, Esther CR Jr, Debley JS, Sockrider M, Yilmaz O, Amin N, et al. Official American Thoracic Society Clinical Practice Guidelines: Diagnostic Evaluation of Infants with Recurrent or Persistent Wheezing. Am J Respir Crit Care Med. 2016 ;194(3):356-73.
  • Referans4. Boyer D, Barsky E, Papantonakis CM, Pittman J, Ren CL, Esther CR Jr, Wilson KC, Thomson CC. Diagnostic Evaluation of Infants with Recurrent or Persistent Wheezing. Ann Am Thorac Soc. 2016 ;13(11):2057-2059.
  • Referans5. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ; Group Health Medical Associates. Asthma and wheezing in the first six years of life. N Engl J Med 1995;332:133–138.
  • Referans 6.Devulapalli CS, Carlsen KC, Haland G, Munthe-Kaas MC, Pettersen M, Mowinckel P, Carlsen KH. Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax 2008;63: 8–13.
  • Referans7. Bacharier LB, Phillips BR, Bloomberg GR, Zeiger RS, Paul IM, Krawiec M et al. Severe intermittent wheezing in preschool children: a distinct phenotype. J Allergy Clin Immunol. 2007 ;119(3):604-10.
  • Referans8. Tenero L, Piazza M, Piacentini G. Recurrent wheezing in children. Transl Pediatr. 2016 ;5(1):31-6.
  • Referans9. Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics. 2002 ;110(2 Pt 1):315-22.
  • Referans10. Muglia C, Oppenheimer J. Wheezing in Infancy: An Overview of Recent Literature. Curr Allergy Asthma Rep. 2017 11;17(10):67.
  • Referans11. Henderson J1, Granell R, Heron J, Sherriff A, Simpson A, Woodcock A, Strachan DP, Shaheen SO, Sterne JA. Associations of wheezing phenotypes in the first 6 years of life with atopy, lung function and airway responsiveness in mid-childhood. Thorax. 2008 ;63(11):974-80.
  • Referans12. Savenije OE1, Granell R, Caudri D, Koppelman GH, Smit HA, Wijga A, de Jongste JC, Brunekreef B, Sterne JA, Postma DS, Henderson J, Kerkhof M. Comparison of childhood wheezing phenotypes in 2 birth cohorts: ALSPAC and PIAMA. J Allergy Clin Immunol. 2011 ;127(6):1505-12.e14.
  • Referans13. Rusconi F, Galassi C, Corbo GM, et al. Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group. Am J Respir Crit Care Med 1999.
  • Referans14. Alper Gürz A , Artıran İğde F.A, Dikici M.F , Yarış F. Birinci Basamakta Hışıltılı Çocuğa Yaklaşım. Turkısh Journal Of Famıly Medıcıne And Prımary Care 2013 ;7(2):18-25.
  • Referans15. Rajkumar V, Rajendra B, How CH, Ang SB. Wheeze in childhood: is the spacer good enough? Singapore Med J. 2014 ;55(11):558-62.
  • Referans16. de Sousa RB, Medeiros D, Sarinho E, Rizzo JÂ, Silva AR, Bianca AC.Risk factors for recurrent wheezing in infants: a case-control study. Rev Saude Publica. 2016;50:15.
  • Referans17. Singh S, Sharma BB, Sharma SK , Sabir M, Singh V; ISAAC collaborating investigators. Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution. J Asthma. 2016;53(3):238-44.
  • Referans18. den Dekker HT, Sonnenschein-van der Voort AM, de Jongste JC, Reiss IK, Hofman A, Jaddoe VW, Duijts L. Tobacco Smoke Exposure, Airway Resistance, and Asthma in School-age Children: The Generation R Study. Chest. 2015 ;148(3):607-17.
  • Referans19. O'Callaghan-Gordo C1, Bassat Q, Díez-Padrisa N, Morais L, Machevo S, Nhampossa T, Quintó L, Alonso PL, Roca A. Lower respiratory tract infections associated with rhinovirus during infancy and increased risk of wheezing during childhood. A cohort study. PLoS One. 2013 31;8(7):e69370.
  • Referans20.Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. Eur Respir J. 2015 ;45(3):774-89.
  • Referans21. Guilbert TW, Morgan WJ, Krawiec M, Lemanske RF Jr, Sorkness C, Szefler SJ et al. The Prevention of Early Asthma in Kids study: design, rationale and methods forthe Childhood Asthma Research and Education network. Control Clin Trials. 2004 ;25(3):286-310.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Ezgi Ulusoy

Raziye Burcu Güven Bilgin Bu kişi benim

Cem Murat Bal Bu kişi benim

Remziye Tanaç

Figen Gulen

Esen Demir

Yayımlanma Tarihi 15 Haziran 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 51 Sayı: 2

Kaynak Göster

APA Ulusoy, E., Güven Bilgin, R. B., Bal, C. M., Tanaç, R., vd. (2020). Hışıltılı Çocukların Genel Özellikleri. Zeynep Kamil Tıp Bülteni, 51(2), 69-72. https://doi.org/10.16948/zktipb.528048
AMA Ulusoy E, Güven Bilgin RB, Bal CM, Tanaç R, Gulen F, Demir E. Hışıltılı Çocukların Genel Özellikleri. Zeynep Kamil Tıp Bülteni. Haziran 2020;51(2):69-72. doi:10.16948/zktipb.528048
Chicago Ulusoy, Ezgi, Raziye Burcu Güven Bilgin, Cem Murat Bal, Remziye Tanaç, Figen Gulen, ve Esen Demir. “Hışıltılı Çocukların Genel Özellikleri”. Zeynep Kamil Tıp Bülteni 51, sy. 2 (Haziran 2020): 69-72. https://doi.org/10.16948/zktipb.528048.
EndNote Ulusoy E, Güven Bilgin RB, Bal CM, Tanaç R, Gulen F, Demir E (01 Haziran 2020) Hışıltılı Çocukların Genel Özellikleri. Zeynep Kamil Tıp Bülteni 51 2 69–72.
IEEE E. Ulusoy, R. B. Güven Bilgin, C. M. Bal, R. Tanaç, F. Gulen, ve E. Demir, “Hışıltılı Çocukların Genel Özellikleri”, Zeynep Kamil Tıp Bülteni, c. 51, sy. 2, ss. 69–72, 2020, doi: 10.16948/zktipb.528048.
ISNAD Ulusoy, Ezgi vd. “Hışıltılı Çocukların Genel Özellikleri”. Zeynep Kamil Tıp Bülteni 51/2 (Haziran 2020), 69-72. https://doi.org/10.16948/zktipb.528048.
JAMA Ulusoy E, Güven Bilgin RB, Bal CM, Tanaç R, Gulen F, Demir E. Hışıltılı Çocukların Genel Özellikleri. Zeynep Kamil Tıp Bülteni. 2020;51:69–72.
MLA Ulusoy, Ezgi vd. “Hışıltılı Çocukların Genel Özellikleri”. Zeynep Kamil Tıp Bülteni, c. 51, sy. 2, 2020, ss. 69-72, doi:10.16948/zktipb.528048.
Vancouver Ulusoy E, Güven Bilgin RB, Bal CM, Tanaç R, Gulen F, Demir E. Hışıltılı Çocukların Genel Özellikleri. Zeynep Kamil Tıp Bülteni. 2020;51(2):69-72.