Öz
Giriş
Astımlı çocuklarda çeşitli inhalan alerjen duyarlılıkları, astım semptomları ve alevlenmeleri ile yakından ilişkilidir. Bu çalışmada, astım tanısı almış 3-6 yaş grubu çocuklarda alerjen duyarlılıklarının çeşitli özelliklerinin ve eşlik eden diğer alerjik hastalıklarla ilişkilerinin araştırılması amaçlanmıştır.
Gereç ve Yöntem
Astım tanısı alan toplam 239 çocuk (3-6 yaş) hasta çalışmaya dahil edilmiştir. Astıma eşlik eden diğer alerjik hastalık tanıları, alerjen duyarlılıkları (alerjenlerle deri prick ve serum alerjen spesifik IgE testleri ile), total IgE test sonuçları, alerjen duyarlılıklarının yaşlara göre dağılımı, retrospektif olarak analiz edilmiştir.
Bulgular
Astımlı çocukların %46,4’ünde en az bir alerjene karşı duyarlılık saptandı ve atopik olarak tanımlandı. Astımlı çocuklarda yaş gruplarına göre atopi saptanma oranları sırasıyla; 36-47 ay grubunda %38,4, 48-59 ay grubunda %47,3 ve 60-72 ay grubunda %50 olarak tespit edilmiştir (p=0,39). Tüm çalışma populasyonunda alerjen duyarlılıkları en sık %29,7 oranında akarlara ve %23 oranında polenlere karşı saptandı. Astımlı çocuklarda inhalan alerjen duyarlılıkları yaş ile birlikte artış eğilimi göstermiştir. Akarlar için duyarlılık oranları; 36-47 ay grubunda %17,3, 48-59 ay grubunda %31,2 ve 60-72 ay grubunda %35,1 olarak tespit edilmiştir (p=0,073). Polenlere duyarlılıkları oranları; 36-47 ay grubunda %1,9, 48-59 ay grubunda %13 ve 60-72 ay grubunda %44,6 bulundu (p=0,001). Besin alerjenlerine duyarlılık oranlarının yaşla birlikte azalma eğiliminde olduğu tespit edilmiştir. Atopik astımlılarda her 3 yaş grubunda da, total IgE değerlerinin atopik bulunmayan çocuklara göre, daha yüksek olduğu görülmüştür (p=0,000-0,002). Astımlı çocuklarda en sık eşlik eden alerjik hastalıklar; alerjik rinit (%44,4), atopik dermatit (%25,1) ve alerjik konjonktivit %8,8 olarak belirlendi. Astımlı çocuklarda ek olarak alerjik rinitin birlikte bulunduğu olgularda, alerjik rinitin bulunmadığı olgulara kıyasla akarlara (%56,3’e karşı %43,7) ve polenlere (%72,7’ye karşı %27,3) duyarlılık oranlarının daha yüksek olduğu tespit edilmiştir.
Sonuç
Astımlı çocuklarda inhalan alerjen duyarlılıkları yaş ile birlikte artış eğilimi gösterirken, besin alerjen duyarlılıklarının yaş ile azalma eğiliminde olduğu görülmektedir. Astım tanılı çocuklarda alerjen duyarlılıklarının saptanması ve komorbid alerjik hastalıkların belirlenmesi gereklidir, bu hastaların tanı ve tedavi süreçlerinde göz önünde tutulması ve ek olarak izlemlerinde tekrar değerlendirilmesi gereken bir konu olduğu düşünülmüştür.
Anahtar Kelimeler: Astım, çocuk, alerjen, duyarlılık, atopi, alerjik rinit
Kaynakça
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