Alerjik rinitli çocuklarda alerjen duyarlılıklarının araştırılması
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Date
2013
Authors
Çelik, Uğur
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Publisher
Uludağ Üniversitesi
Abstract
Çocukluk çağında alerjik rinitli olgularda prik testi ile alerjen duyarlılık oranlarını ve ilişkili faktörleri araştıran çalışmalar kısıtlı sayıdadır. Bu çalışma alerjik rinit tanısı almış olan çocuk olgularda çeşitli allerjenlere karşı duyarlılık oranlarının, allerjen duyarlılığına etki eden çeşitli faktörlerin (cinsiyet, yaş v.b.) saptanması, allerjen duyarlılıklarının birlikte görülme oranlarının araştırılması amacı ile planlanmıştır. Uludağ Üniversitesi Tıp Fakültesi Çocuk Alerji Bilim Dalı Polikliniği'ne 01.01.2006-30.09.2012 tarihleri arasında ardışık olarak başvurmuş olan ve alerjenlerle deri prik testinde herhangi bir alerjene karşı duyarlılık saptanmış 1139 alerjik rinit tanılı olgu retrospektif olarak çalışmaya alındı. Çalışmada yer alan olguların 680'i (%59,7) erkek ve 459'u (%40,3) kız idi. Olguların ortalama tanı yaşı 8,35±3,67 yıl, semptomların başlangıç zamanı 6,42±3,32 yıl idi. Alerjik rinite en sık astım (%28) ve alerjik konjonktivit (%17,82) eşlik etmekteydi. Ailede herhangi bir alerjik hastalık öyküsü %35,9 olguda mevcuttu. Çalışma popülasyonumuzu oluşturan alerjik rinitli çocuklarda prik testi ile en sık genel akar duyarlılığı (%68,8) daha sonra ise sırayla genel polen duyarlılığı (%56,5), genel evcil hayvan duyarlılığı (kedi ve/veya köpek) %12,6, genel mantar duyarlılığı %10,2, hamam böceği duyarlılığı %5, genel besin duyarlılığı %3,3, lateks duyarlılığı %3,3 saptandı. Alerjenler tek başlarına incelendiğinde en sık D. pteronyssinus %68,1, D. farinae %65,6 ve çimen polen karışımı %54,2, Phleum pratense %46,9, Cynodon dactylon %45,9, tahıl polen karışımı %44,6, Secale cereale %43,4 duyarlılıkları saptandı. Alerjik rinitli olgularda cinsiyete göre alerjen duyarlılıkları incelendiğinde; çimen polen karışımı, Phleum pratense, Cynodon dactylon, Dactylis glomerata, Lolium perene, tahıl polen karışımı, Secale cereale, Avena sativa ve Triticum sativum alerjenlerine karşı duyarlılığın erkeklerde kızlara göre istatistiksel anlamlı olarak daha yüksek ve yer fıstığı, yumurta akı ve inek sütü alerjenlerine karşı duyarlılığın ise kızlarda erkeklere göre daha istatistiksel anlamlı olarak daha yüksek saptandığı bulundu. Alerjik rinitli olguların en az olarak 0-3 yaş grubunda (%0,49), 3,01-6 yaş grubunda (%6,23) ve 6,01-9 yaş grubunda (%18,87) bulunduğu saptandı. Genel polen grubu alerjenler için duyarlılık oranlarının yaşla paralel olarak arttığı (0-3 yaş grubundaki olgularda %0, 3,01-6 yaş gurubundaki olgularda % 35,2, 6,01-9 yaş grubundaki olgularda %44,6, 9,01-12 yaş gubundaki olgularda %58,8, 12,01-15 yaş grubundaki olgularda %60,5 ve >15 yaş grubundaki olgularda %66,6) saptandı. Sadece alerjik rinitli olgularda en sık genel akar (%73,0), alerjik rinitli astımlı olgularda en sık genel akar (%71,5), alerjik rinitli ve alerjik konjonktivitli olgularda en sık genel polen (%64,6) ve alerjik rinitli ve astımlı ve alerjik konjonktivitli olgularda en sık genel polen (%67,5) duyarlılıkları saptandı. Alerjik rinitli olgularda ailede alerjik hastalık öyküsüne göre alerjen duyarlılıkları incelendiğinde; alerjenlerin geneli için duyarlılık oranları ailesinde alerjik hastalık öyküsü olanlarda olmayanlara göre istatatistiksel anlamlı olarak daha yüksek saptandı. Alerjik rinitli olguların yaşadığı yere göre alerjen duyarlılıkları incelendiğinde; Plantago lanceolata, Aspergillus fumigatus, Penicillium notatum ve hamam böceği duyarlılığı kırsal bölgede yaşayanlarda kentsel bölgede yaşayanlara göre istatistiksel anlamlı olarak daha yüksek saptandı. Çalışmamızda alerjik rinitli çocuklarda en sık akar ve çeşitli polen duyarlılıkları saptanmıştır. Çocukluk yaş grubunda ve tümü alerjik rinitli olgulardan oluşan bu çalışma popülasyonundan elde edilen verilerin alerjik rinitli hastaların değerlendirmelerinde ve takiplerinde göz önünde bulundurulmasının faydalı olacağı düşünülmüştür.
There are limited numbers of studies which are investigating allergen sensitization rates and related factors by using the skin prick test on cases with allergic rhinitis within childhood. This study has been planned with the purpose of investigating sensitization rates versus various allergens, detecting various factors effecting allergen sensitization (gender, age, etc.) and investigating concurrently rates of allergen sensitization on allergic rhinitis diagnosed child patients. Allergic rhinitis diagnosed 1139 cases, who sequentially presented Uludağ University Medical School's Pediatric Allergies Policlinic between 01.01.2006 and 09.30.2012 and has sensitization to any of allergens on skin prick test are taken into study retrospectively. The distribution of patients according to sex was 680 males (59.7%) and 459 females (40.3%). The mean age at diagnosis of the 1139 participants with allergic rhinitis was 8.35±3.67 years; the occurrence time of the symptoms was 6.42±3.32 years. Asthma accompanied allergic rhinitis in 319 patients (28%) and allergic conjunctivitis in 203 (17,82%). On 35.9% of the cases, any allergic disease was present in family medical history. Mite sensitivity was the most severe of all with 68.8% in our population which is constituted by children diagnosed allergic rhinitis on prick test and it is followed by respectively pollen sensitivity with 56.5%, overall pet sensitivity (cat and/or dog) with 12.6%, overall mould sensitivity with 10.2%, cockroach sensitivity with 5.0%, overall food sensitivity with 3.3% and latex sensitivity with 3.3%. When separetely investigate allergen sensitization, sensitivity rates has been detected D. pteronyssinus 68.1%, D. farina 65.6%, grass pollen mixture 54.2%, Phleum pretense 46.9% Cynodon dactylon 45.9%, cereal pollen mixture 44.6% and Secale cereale 43.4%. Allergic rhinitis cases least seen in 0-3 age group with 0.49%, in 3.01-6 age groups with 6.23% and in 6.01-9 age group with 18.87%. It has been detected that sensitivity to overall pollen group allergens increased parallel to age (0% of 0-3 aged cases, 35.2% of 3.01-6 aged cases, 44.6% of 6.01-9 aged cases, 58.8% of 9.01-12 aged cases, 60.5% of 12.01-15 aged cases and 66.6% of cases which are aged greater than 15). Cases only have allergic rhinitis most frequently had mite sensitivity (73.0%). Cases have both allergic rhinitis and asthma had most frequently had mite sensitivity (71.5%). Cases have both allergic rhinitis and allergic conjunctivitis had most frequently general pollen sensitivity (64.6%). Cases have both allergic rhinitis, asthma and allergic conjunctivitis had most frequently general pollen sensitivity (67.5%). In allergic rhinitis cases that have parents with allergic disease in medical history had statistically meaningfully higher sensitivity to allergens than the others. It has been found that according to the place of residence, Plantago lanceolata, Aspergillus fumigatus, Penicillium notatum and cockroache sensitivities were statistically meaningfully higher in ones who live rural areas than the ones who live in urban areas. It has been found that according to gender grass pollen mixture, Phleum pratense, Cynodon dactylon, Dactylis glomerata, Lolium perene, cereale pollen mixture, Secale cereale, Avena sativa and Triticum sativum sensitivities were statistically meaningfully higher males than females and peanut, egg white, cow milk sensitivities were statistically meaningfully higher females than male. In our study, children with allergic rhinitis had most frequently mite and various pollen sensitivities. It is considered beneficial to take into consideration the data, which is obtained from our study group that solely constituted by children who all have allergic rhinitis, while examining and following up allergic rhinitis patients.
There are limited numbers of studies which are investigating allergen sensitization rates and related factors by using the skin prick test on cases with allergic rhinitis within childhood. This study has been planned with the purpose of investigating sensitization rates versus various allergens, detecting various factors effecting allergen sensitization (gender, age, etc.) and investigating concurrently rates of allergen sensitization on allergic rhinitis diagnosed child patients. Allergic rhinitis diagnosed 1139 cases, who sequentially presented Uludağ University Medical School's Pediatric Allergies Policlinic between 01.01.2006 and 09.30.2012 and has sensitization to any of allergens on skin prick test are taken into study retrospectively. The distribution of patients according to sex was 680 males (59.7%) and 459 females (40.3%). The mean age at diagnosis of the 1139 participants with allergic rhinitis was 8.35±3.67 years; the occurrence time of the symptoms was 6.42±3.32 years. Asthma accompanied allergic rhinitis in 319 patients (28%) and allergic conjunctivitis in 203 (17,82%). On 35.9% of the cases, any allergic disease was present in family medical history. Mite sensitivity was the most severe of all with 68.8% in our population which is constituted by children diagnosed allergic rhinitis on prick test and it is followed by respectively pollen sensitivity with 56.5%, overall pet sensitivity (cat and/or dog) with 12.6%, overall mould sensitivity with 10.2%, cockroach sensitivity with 5.0%, overall food sensitivity with 3.3% and latex sensitivity with 3.3%. When separetely investigate allergen sensitization, sensitivity rates has been detected D. pteronyssinus 68.1%, D. farina 65.6%, grass pollen mixture 54.2%, Phleum pretense 46.9% Cynodon dactylon 45.9%, cereal pollen mixture 44.6% and Secale cereale 43.4%. Allergic rhinitis cases least seen in 0-3 age group with 0.49%, in 3.01-6 age groups with 6.23% and in 6.01-9 age group with 18.87%. It has been detected that sensitivity to overall pollen group allergens increased parallel to age (0% of 0-3 aged cases, 35.2% of 3.01-6 aged cases, 44.6% of 6.01-9 aged cases, 58.8% of 9.01-12 aged cases, 60.5% of 12.01-15 aged cases and 66.6% of cases which are aged greater than 15). Cases only have allergic rhinitis most frequently had mite sensitivity (73.0%). Cases have both allergic rhinitis and asthma had most frequently had mite sensitivity (71.5%). Cases have both allergic rhinitis and allergic conjunctivitis had most frequently general pollen sensitivity (64.6%). Cases have both allergic rhinitis, asthma and allergic conjunctivitis had most frequently general pollen sensitivity (67.5%). In allergic rhinitis cases that have parents with allergic disease in medical history had statistically meaningfully higher sensitivity to allergens than the others. It has been found that according to the place of residence, Plantago lanceolata, Aspergillus fumigatus, Penicillium notatum and cockroache sensitivities were statistically meaningfully higher in ones who live rural areas than the ones who live in urban areas. It has been found that according to gender grass pollen mixture, Phleum pratense, Cynodon dactylon, Dactylis glomerata, Lolium perene, cereale pollen mixture, Secale cereale, Avena sativa and Triticum sativum sensitivities were statistically meaningfully higher males than females and peanut, egg white, cow milk sensitivities were statistically meaningfully higher females than male. In our study, children with allergic rhinitis had most frequently mite and various pollen sensitivities. It is considered beneficial to take into consideration the data, which is obtained from our study group that solely constituted by children who all have allergic rhinitis, while examining and following up allergic rhinitis patients.
Description
Keywords
Çocuk, Alerjik rinit, Alerjen, Duyarlılık, Atopi, Prik test, Children, Allergic rhinitis, Allergen, Sensitization, Atopy, Prick test
Citation
Çelik, Y. (2013). Alerjik rinitli çocuklarda alerjen duyarlılıklarının araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.