RESUMEN
INTRODUCTION: Allergic sensitization of the airways occurs not only in the mucosa of the shock organ, but also in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid. Many researches show that in part of children allergic rhinitis can be a risk factor for adenoid hypertrophy. MATERIALS AND METHODS: We used acoustic rhinometry and endoscopy to evaluate the influence of the birch pollination on the adenoid size in 67 children between 5 and 12 years old. Four separate groups of children were examined. The study group consisted of 28 children hypersensitive to tree pollen with seasonal allergic rhinitis (interview, positive skin prick test results, presence of sIgE in the serum and positive nasal provocation test with birch pollen allergens). The first control group consisted of 14 atopic children hypersensitive to motherwort pollen. The second control group consisted of 15 non-atopic children. The third control group consisted of 10 children hypersensitive to tree pollen, they have got anti-allergic treatment (topical nasal steroid and antihistaminic) a week before birch pollination. In all of the groups the adenoid size was examined before, during and after birch pollination. In the study group, we examined the influence of specific nasal provocation test on the adenoid size too. RESULTS: In most children from the study group (71.4%) we observed the significant increase of adenoid size in endoscopic examination and decrease of nasopharyngeal cavity volume in acoustics rhinometry (92.9%) during the birch pollination. The changes returned after pollination period in most children (90%). In the first and the second control group there were almost no changes observed (p>0.05). The medical treatment used in the third control group avoided the increase of adenoid size during birch pollination season. In the study group there was no statistically significant correlation between the changes in nasopharyngeal volume during the pollination period and the results of nasal provocation test (r=0.18). CONCLUSION: The result of our study suggests that in children with seasonal allergic rhinitis the exposure on the allergenic factor can influence the adenoid size. Properly administered nasal glucocorticoid together with antihistaminic in standard doses can probably avoid this effect.
Asunto(s)
Tonsila Faríngea/patología , Betula , Polen/efectos adversos , Rinitis Alérgica Estacional/fisiopatología , Tonsila Faríngea/efectos de los fármacos , Niño , Preescolar , Dermatitis Atópica/etiología , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Mucosa Respiratoria/efectos de los fármacos , Mucosa Respiratoria/patología , Rinitis Alérgica Estacional/etiología , Rinometría AcústicaRESUMEN
INTRODUCTION: The adenoidectomy is the most often made operation in small children but the reasons of adenoid hypertrophy are not completely explained. Some researches show that in part of children, allergy can be a risk factor for adenoid hypertrophy. The main aim of this study was the analysis of adenoid hypertrophy in children with different allergic diseases. MATERIAL AND METHODS: Two separate groups of children were examined. The study group consisted of 436 children between 4 and 9 years old with allergic rhinitis and/or bronchial asthma and/or atopic dermatitis hypersensitive to house dust mites (interview, positive skin-prick test results). The control group consisted of 229 non-atopic children (negative interview and skin-prick tests) in the similar age. In the both groups we examined the incidence of adenoid hypertrophy and its dependence of the kind of allergic disease, age, sex, infections, results of skin-prick test and other sensitization. RESULTS: The probability of adenoid hypertrophy was statistically more significant (logistic regression analysis) only in children from the study group with allergic rhinitis. There were no differences in adenoid hypertrophy incidence between children with other allergic diseases and the control group. The children from the study group with adenoid hypertrophy were more often hypersensitive to pollen and moulds allergens than the children without adenoid hypertrophy (chi square test). But there were no differences in the incidence of infection, age, sex and results of skin-prick tests. CONCLUSION: The result of our study suggests that the chance of adenoid hypertrophy in allergic children hypersensitive to dust mites is greater only in them with allergic rhinitis.
Asunto(s)
Tonsila Faríngea/patología , Hipersensibilidad Inmediata/epidemiología , Rinitis Alérgica Estacional/epidemiología , Tonsila Faríngea/diagnóstico por imagen , Animales , Niño , Preescolar , Femenino , Humanos , Hipersensibilidad Inmediata/inmunología , Hipertrofia/epidemiología , Hipertrofia/patología , Masculino , Prevalencia , Pyroglyphidae/inmunología , Radiografía , Rinitis Alérgica Estacional/inmunologíaRESUMEN
UNLABELLED: Although adenoidectomy is the most frequently performed surgical operation in small children, the causes of adenoid hypertrophy are not completely explained. Certain studies indicate that in some children it is an allergy that can constitute a risk factor for adenoid hypertrophy. The main aim of this study was the analysis of atopic allergy in children with adenoid hypertrophy. MATERIAL AND METHODS: Two separate groups of children aged between 4 and 10 years with nasal obstruction were examined. The study group consisted of 796 children with adenoid hypertrophy. The control group consisted of 297 children without adenoid hypertrophy. In all of the children a skin prick test was performed and the frequency of occurrence of typical allergic diseases was estimated. RESULTS: The skin prick test was positive in about 19% of children in both groups under examination (no statistical differences). In children from the study group the allergic rhinitis occurred significantly more often than in the group without hypertrophy (p = 0.0000). The hypersensitivity to dust mites was demonstrated in the study group more often as well (p = 0.0007). The results were confirmed by logistic regression. There were no differences in the frequency of atopic dermatitis and bronchial asthma between both groups compared. CONCLUSIONS: In children with adenoid hypertrophy allergic rhinitis was the most commonly found allergic disease which seems to be the risk factor for adenoid hypertrophy in hypersensitive children.
Asunto(s)
Tonsila Faríngea , Hipertrofia , Asma , Niño , Dermatitis Atópica , Humanos , HipersensibilidadRESUMEN
BACKGROUND: Allergic sensitization of the airways occurs not only in the mucosa of the shock organ, but also in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid. Many researches show that in part of children allergic rhinitis can be a risk factor for adenoid hypertrophy. MATERIAL AND METHODS: We examined changes in clinical symptoms score, and used acoustic rhinometry and endoscopy to evaluate the influence of three months anti-allergic treatment (topical nasal steroid and antihistaminic) on the adenoid size in children with adenoid hypertrophy. Three separate groups of children were examined. The study group consisted of 31 children with adenoid hypertrophy and perennial allergic rhinitis (interview, positive skin-prick test results, presence of sIgE in the serum and positive nasal provocation test with dust allergens). The first control group consisted of 23 atopic children hypersensitive to dust allergens (positive skin-prick test results, presence of sIgE in the serum) with adenoid hypertrophy but without signs of perennial allergic rhinitis and with negative nasal provocation test. This group was not treated. The second control group consisted of 20 non-allergic children with adenoid hypertrophy. The children were treated similar to the children from the study group. RESULTS: In children from the study group we observed the most significant decrease of clinical symptoms and endoscopic adenoid size and increase of nasopharyngeal cavity in acoustics rhinometry after the treatment. In the first control group there were almost no changes and in the second control group, the improvement concern only 25% of children. The medical treatment had however no statistical important influence on the tympanometry results in all the examined groups. CONCLUSION: Properly administered nasal glucocorticoid spray together with antihistaminic in standard doses can significantly reduce adenoidal hypertrophy and considerably eliminate airway obstructive symptoms in children with allergic rhinitis. Likely only in this children the antiallergic treatment can be a useful alternative to surgery.
Asunto(s)
Tonsila Faríngea/patología , Antialérgicos/administración & dosificación , Glucocorticoides/administración & dosificación , Rinitis Alérgica Perenne/complicaciones , Rinitis Alérgica Perenne/tratamiento farmacológico , Tonsila Faríngea/efectos de los fármacos , Administración Intranasal , Niño , Preescolar , Femenino , Antagonistas de los Receptores Histamínicos H1/administración & dosificación , Humanos , Hipertrofia/tratamiento farmacológico , Hipertrofia/etiología , Hipertrofia/patología , Masculino , Nasofaringe/efectos de los fármacos , Nasofaringe/patología , Rinitis Alérgica Perenne/patología , Rinometría Acústica/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Allergic rhinitis is considered a risk factor for bronchial asthma. It therefore seems essential to identify patients threatened with this disease in whom no disturbing bronchial symptoms have occurred. The study's aim was to evaluate the incidence of nonspecific bronchial hyperactivity based on exercise results in pollinosis patients. MATERIAL/METHODS: The study group comprised 27 patients with seasonal allergic rhinitis allergic to tree pollens but without asthma symrptom. Exercise provocation tests were performed before, during, and after completion of the pollination period. During the pollination period, specific IgE (sIgE) and nasal eosinophilia were also determined. Twelve patients allergic to Artemisia pollen made up the control group. The results were also evaluated in relation to desensitization therapy. RESULTS: In the study group a pathological result of the provocation test was obtained in 1 patient (3.7%) before the pollination period, in 7 patients (25.9%) during, and in 4 patients (11.8%) after its completion. The subjects with a positive test result had higher levels of nasal eosinophilia, while there was no relation between the result and sIgE levels. Only one case of positive exercise challenge was identified among the desensitized patients. CONCLUSIONS: During the pollination period, nonspecific bronchial hyperreactivity develops in some patients with seasonal allergic rhinitis; it can be sustained for some time after the disappearance of pollens from the atmosphere and can he identified using an exercise challenge. Incidence of bronchial hyperreactivity in desensitized patients was lower than in those subjected to symptomatic treatment.
Asunto(s)
Hiperreactividad Bronquial/epidemiología , Polen/inmunología , Rinitis Alérgica Estacional/inmunología , Adolescente , Adulto , Eosinofilia/diagnóstico , Femenino , Humanos , Inmunoglobulina A Secretora/análisis , Masculino , Pruebas de Provocación Nasal , Factores de RiesgoRESUMEN
Nonallergic rhinitis with eosinophilia is characterized by persistent nasal symptoms without allergy and by a marked eosinophil recruitment in the nasal cavities. The incidence of it is more than 15% among all types of rhinitis. A part of them is caused by nonsteroidal anti-inflammatory drugs hypersensivity. For this study 114 patients were selected on the basis of perennial rhinitis, the absence of allergy and with an eosinophil count higher than 10% of total leukocytes in nasal cytology. In all of them the nasal provocation test with lysine-aspirin was made. The clinical response was evaluated based on nasal symptoms (sneezes, itching, secretion and blockage). The nasal response was measured by acoustic rhinometry. The results of the test was positive in 19 cases, mostly in patients with nasal polyps, bronchial asthma and higher level of nasal eosinophilia (differences statistically significant). The count of nasal eosinophilia corresponded better with the decrease of nasal volume in acoustic rhinometry (r = 0,84) then with the clinical score (r = 0,52). The nasal challenge was well tolerated by almost all subjects. We conclude that the nasal challenge with lysine-aspirin is safe and can be helpful as a diagnostic test in patients with nonallergic rhinitis with eosinophilia.
Asunto(s)
Antiinflamatorios no Esteroideos , Aspirina/análogos & derivados , Eosinofilia/diagnóstico , Lisina/análogos & derivados , Pruebas de Provocación Nasal/métodos , Rinitis/diagnóstico , Administración Intranasal , Adulto , Anciano , Antiinflamatorios no Esteroideos/efectos adversos , Aspirina/efectos adversos , Asma/complicaciones , Relación Dosis-Respuesta a Droga , Ensayo de Inmunoadsorción Enzimática , Eosinofilia/etiología , Femenino , Humanos , Lisina/efectos adversos , Masculino , Persona de Mediana Edad , Pólipos Nasales/complicaciones , Rinitis/etiologíaRESUMEN
INTRODUCTION: Allergic sensitization of the airways occurs not only in the mucosa of the shock organ, but also in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid. Many researches show that in part of children allergic rhinitis can be a risk factor for adenoid hypertrophy. MATERIAL AND METHODS: We used acoustic rhinometry and endoscopy to evaluate the influence of the birch pollination on the adenoid size in 67 children between 5 and 12 years old. Four separate groups of children were examined. The study group consisted of 28 children hypersensitive to tree pollen with seasonal allergic rhinitis (interview, positive skin-prick test results, presence of sIgE in the serum and positive nasal provocation test with birch pollen allergens). The first control group consisted of 14 atopic children hypersensitive to motherwort pollen. The second control group consisted of 15 non-atopic children. The third control group consisted of 10 children hypersensitive to tree pollen, they have got antiallergic treatment (topical nasal steroid and antihistaminic) a week before birch pollination. In all of the groups the adenoid size was examined before, during and after birch pollination. In the study group we examined the influence of specific nasal provocation test on the adenoid size too. RESULTS: In most children from the study group (71.4%) we observed the significant increase of adenoid size in endoscopic examination and decrease of nasopharyngeal cavity volume in acoustics rhinometry (92.9%) during the birch pollination. The changes returned after pollination period in most children (90%). In the first and the second control group there were almost no changes observed (p > 0.05). The medical treatment used in the third control group avoided the increase of adenoid size during birch pollination season. In the study group there was no statistically significant correlation between the changes in nasopharyngeal volume during the pollination period and the results of nasal provocation test (r = 0.18). CONCLUSION: The result of our study suggests that in children with seasonal allergic rhinitis the exposure on the allergenic factor can influence the adenoid size. Properly administered nasal glucocorticoid together with antihistaminic in standard doses can probably avoid this effect.
Asunto(s)
Tonsila Faríngea/patología , Alérgenos/análisis , Betula , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente/estadística & datos numéricos , Polen/clasificación , Rinitis Alérgica Perenne/patología , Tonsila Faríngea/efectos de los fármacos , Niño , Preescolar , Endoscopía , Femenino , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Hipertrofia/patología , Masculino , Pruebas de Provocación Nasal , Estudios Retrospectivos , Rinitis Alérgica Perenne/tratamiento farmacológico , Rinitis Alérgica Perenne/etiología , Rinometría Acústica/métodosRESUMEN
UNLABELLED: The adenoidectomy is the most often made operation in small children but the reasons of adenoid hypertrophy are not completely explain. Some researches show that in part of children allergy can be a risk factor for adenoid hypertrophy. The main aim of this study was the analysis of adenoid hypertrophy in children with different allergic diseases. MATERIAL AND METHODS: Two separate groups of children were examined. The study group consisted of 436 children between 4 and 9 years old with allergic rhinitis and/or bronchial asthma and/or atopic dermatitis hypersensitive to house dust mites (interview, positive skin-prick test results). The control group consisted of 229 non-atopic children (negative interview and skin-prick tests) in the similar age. In the both groups we examined the incidence of adenoid hypertrophy and its dependence of the kind of allergic disease, age, sex, infections, results of skin-prick test and other sensitisation. RESULTS: The probability of adenoid hypertrophy was statistically more significant (logistic regression analysis) only in children from the study group with allergic rhinitis. There were no differences in adenoid hypertrophy incidence between children with other allergic diseases and the control group. The children from the study group with adenoid hypertrophy were more often hypersensitive to pollen and moulds allergens than the children without adenoid hypertrophy (chi square test). But there were no differences in the incidence of infection, age, sex and results of skin-prick tests. CONCLUSION: The result of our study suggests that the chance of adenoid hypertrophy in allergic children hypersensitive to dust mites is greater only in them with allergic rhinitis.
Asunto(s)
Tonsila Faríngea/patología , Pyroglyphidae , Hipersensibilidad Respiratoria/epidemiología , Hipersensibilidad Respiratoria/inmunología , Tonsila Faríngea/inmunología , Alérgenos , Animales , Hiperreactividad Bronquial/epidemiología , Hiperreactividad Bronquial/inmunología , Niño , Preescolar , Comorbilidad , Dermatitis Atópica/epidemiología , Dermatitis Atópica/inmunología , Femenino , Humanos , Hipertrofia/epidemiología , Incidencia , Modelos Logísticos , Masculino , Pruebas de Provocación Nasal , Polonia/epidemiología , Estudios Retrospectivos , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Perenne/inmunología , Pruebas CutáneasRESUMEN
The tonsils are part of Waldeyer's ring, the basic function of which is antibody formation; they react later against a wide variety of antigens. Allergic sensitization of the airways occurs not only in the mucosa of the afflicted organ, but also in the lymphatic stations draining these structures. The lymphatic structures closest to the nasal mucosa in humans are the adenoids and tonsils. Adenoidal, nasal, and middle ear diseases are frequent health problems in young children. Pediatric adenoidal obstruction of the nasal airway is associated with significant morbidity and is also a frequent indication for surgery. Research done with respect to Waldeyer's ring in people dealing concurrently with allergy is a seldom subject in medical literature, both Polish and world wide. The study shows that allergy and sensitivity to different kinds of allergens are risk factors for adenoid hypertrophy (AH) in children. Histopathological and immunohistochemical studies confirms that tonsil dendritic cells, macrophages, eosinophils, and mast cells are involved in and are important in allergic tonsillitis. Ig synthesis and switching also occur in the adenoid and tonsils. Early treatment of allergic diseases may help reduce the occurrence of AH. Properly administered nasal steroids and antihistamines can reduce adenoidal hypertrophy and nasal airway obstructive symptoms in atopic children.
Asunto(s)
Hipersensibilidad/inmunología , Tonsilitis/inmunología , Formación de Anticuerpos , Niño , Humanos , Inmunoglobulina G/biosíntesis , Tonsilitis/patología , Tonsilitis/terapiaRESUMEN
BACKGROUND: Many studies have shown that specific immunotherapy may prevent the development of allergies to new allergens. Recently, however, there have been sporadic reports on the possibility of new allergies developing during immunotherapy. The aim of this study was to evaluate the possibility of the occurrence of food allergy and changes of sIgE concentration in patients sensitive to tree pollen during specific immunotherapy. MATERIAL/METHODS: We examined 12 patients subjected to desensitization treatment of pollinosis caused by allergy to the pollen of Betulaceae trees, in whom only Bet v 1 sIgE was found in serum prior to immunotherapy. The control group included 8 allergic patients who did not consent to this treatment. RESULTS: Bet v 2 sIgE was detected after 6 months in 3 patients (25%) and after 18 months in another 2 patients (41.7% total). In 2 cases, oral allergy syndrome (OAS) occurred in the course of therapy. These findings were accompanied by a concomitant decrease in nasal and ocular allergic signs during the birch pollen season in the overwhelming majority of patients (91.7%). In the control group, no serum occurrence of Bet v 2 sIgE was found during the 18-month observation period. Although no OAS signs appeared in any patient, the symptomatic intensity of pollinosis was not reduced. CONCLUSIONS: Due to the limitations of currently used vaccines, new allergies may be induced during immunotherapy. In sporadic cases these may be accompanied by the occurrence of specific clinical manifestations, usually mild.
Asunto(s)
Betula/inmunología , Desensibilización Inmunológica/efectos adversos , Hipersensibilidad/terapia , Polen/inmunología , Adulto , Femenino , Hipersensibilidad a los Alimentos/etiología , Hipersensibilidad a los Alimentos/inmunología , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina E/sangre , Masculino , SíndromeRESUMEN
During this randomized, double blind study versus placebo efficacy of 3 month treatment of patients with chronic sinusitis was assessed. Main efficacy criterion was defined as the change in computed tomography of paranasal sinuses, measured in V. Lund scale. In fenspiride group, overall score changed from 8.54 to 7.57 points (0.97 points i.e. 11.4% decrease, p=0.008), while in placebo group no statistically significant change was observed (change from 9.25 to 9.27 points--0.02 points i.e. 0.2% increase). Percentage of patients who experienced worsening (defined as at least 1 point increase between the beginning and the end of the study) in the placebo group was twice as big as in the fenspiride group (35.4% and 15.2% respectively; p=0.025). Clinical symptoms of chronic sinusitis--sneezing, itchy nose and purulent character of sputum--were decreasing in the fenspiride group significantly more than in the placebo group. Data from previous studies demonstrated beneficial effect of fenspiride treatment of patients with chronic sinusitis. During this study fenspiride treatment was proved to be relatively effective in terms of computed tomography results, and well tolerated during three month therapy.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Broncoconstricción/efectos de los fármacos , Sinusitis/tratamiento farmacológico , Compuestos de Espiro/uso terapéutico , Adulto , Anciano , Antiinflamatorios no Esteroideos/efectos adversos , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Compuestos de Espiro/efectos adversos , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Allergic rhinitis is considered a risk factor for the future development of bronchial asthma. It therefore seems essential to identify patients who are threatened with this disease and in whom no disturbing bronchial symptoms have already occurred. The aim of this study was to evaluate the incidence of nonspecific bronchial hyperactivity based upon exercise results of patients with pollinosis. INVESTIGATED GROUP: The study encompassed 27 patients with seasonal allergic rhinitis allergic to tree pollens, but without symptoms of asthma. Exercise provocation test were performed in patients in the period before, during and after completion of the pollination period. Additionally, during the pollination period sIgE and nasal eosinophilia were determined. The control group was composed of 12 patients allergic to Artemisia pollen. RESULTS: In the study group, a pathological result of provocation test was obtained in 1 patient (3.7%) before the pollination period, in 7 patients (25.9%) during and in 4 patients (14.8%) after completion of the pollination period. Subjects with positive test result had higher levels of nasal eosinophilia, while there was no relation between its result and sIgE levels. Only one case of positive exercise challenge was identified among desensitized patients. CONCLUSIONS: During the pollination period nonspecific bronchial hyperreactivity develops in some patients with seasonal allergic rhinitis; it can be sustained for some time after disappearance of pollens from the atmosphere and can be identified using an exercise challenge. Incidence of bronchial hyperreactivity in desensitized patients was lower than in those subjected to symptomatic treatment.
Asunto(s)
Hiperreactividad Bronquial/diagnóstico , Hiperreactividad Bronquial/terapia , Desensibilización Inmunológica , Prueba de Esfuerzo , Rinitis Alérgica Estacional/diagnóstico , Rinitis Alérgica Estacional/terapia , Estaciones del Año , Adulto , Hiperreactividad Bronquial/epidemiología , Pruebas de Provocación Bronquial , Distribución de Chi-Cuadrado , Femenino , Humanos , Polen , Rinitis Alérgica Estacional/epidemiologíaRESUMEN
BACKGROUND: In the case of allergies to outdoor mould spores and plant pollen allergens, which are often concomitant, doubts may arise as to the role of mould allergens in inducing specific clinical manifestations. Establishing their significance is crucial for qualifying the patient for specific immunotherapy. This information also helps to reduce the percentage of therapeutic failures. MATERIAL/METHODS: The study population comprised 31 patients with seasonal allergic rhinitis who were allergic to both plant pollen allergens and mould spores. In each patient we performed a skin prick test, sIgE level determination, and a specific nasal provocation test using mould allergens, according to standard allergological diagnostic procedure, and the results were objectified using acoustic rhinometry. RESULTS: Positive NPT results were obtained in 22 patients. The positive results were more frequent in persons allergic to Cladosporium herbarum (92.3%) than in those allergic to Alternaria alternata (55.5%); these differences were statistically significant (p = 0.039). No differences were found between the two subgroups in terms of the sIgE levels (p = 0.13). In the study group as a whole, a high correlation between the results of acoustic rhinometry and the intensity of clinical manifestations was observed after administration of the NPT (correlation coefficient of 0.9). The correlation between the sIgE levels and the results of the skin prick tests and the NPT was much lower (0.48 and 0.66, respectively). CONCLUSIONS: The specific nasal provocation test is a safe and easy diagnostic modality, and acoustic rhinometry provides a good method of measuring it.
Asunto(s)
Alérgenos/inmunología , Hipersensibilidad/diagnóstico , Pruebas de Provocación Nasal/métodos , Adulto , Alternaria/inmunología , Cladosporium/inmunología , Femenino , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina E/sangre , Masculino , Polen/inmunología , Rinitis Alérgica Perenne/inmunología , Rinometría Acústica/métodos , Pruebas Cutáneas/métodosRESUMEN
BACKGROUND: In addition to allergen elimination, specific immunotherapy remains the only recognized causal treatment of allergic diseases. Nevertheless, there are no commonly accepted parameters and tests allowing for the evaluation and prediction of its efficacy. The aim of this study was to evaluate the results of readily available supplemental allergy tests and to attempt to associate those findings with the outcome of therapy for desensitized patients. METHODS: This study was conducted in a group of 22 patients receiving specific immunotherapy for perennial allergic rhinitis to dust mites. The results of skin prick tests, sIgE levels, nasal eosinophilia levels as well as specific nasal provocation tests measured by acoustic rhinometry were compared prior to desensitization and two years following the therapy. The control group comprised 17 allergic patients treated without immunotherapy. RESULTS: Apart from the confirmation of immunotherapy efficacy, a positive correlation between its results and the results of the nasal provocation test (correlation coefficient r = 0.85) were demonstrated in this study. No relationship was however found between the obtained result and the results of skin prick tests (r = 0.57) and serum sIgE levels (r = 0.59) or nasal eosinophilia (r = 0.57). The result of acoustic rhinometry corresponded well with clinical manifestations observed in nasal provocation tests. CONCLUSIONS: The specific nasal provocation test is an easy method that may be used for monitoring the efficacy of immunotherapy, and acoustic rhinometry is a good method for measuring its results.
Asunto(s)
Desensibilización Inmunológica , Pruebas de Provocación Nasal/métodos , Rinitis Alérgica Perenne/diagnóstico , Rinitis Alérgica Perenne/terapia , Adulto , Animales , Relación Dosis-Respuesta Inmunológica , Eosinófilos/metabolismo , Femenino , Humanos , Inmunoglobulina E/sangre , Masculino , Ácaros/inmunología , Rinitis Alérgica Perenne/inmunología , Rinometría Acústica/métodos , Pruebas Cutáneas/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Due to the difficulties involved in assessing adenoidal tissue and the nasopharyngeal airway in children, it is necessary to find an accurate pre-operative method of measuring these structures. MATERIAL/METHODS: We used acoustic rhinometry and endoscopy both to the evaluate results of surgical and medical treatment in allergic children with adenoid hypertrophy and to evaluate the influence of pollination on adenoid size in children with seasonal allergic rhinitis. Three separate groups of children were examined. The first group consisted of nine children with adenoid hypertrophy and positive skin-prick test results of year-round allergens. In this group we examined the influence of adenoidectomy on the rhinometric curve. The second group consisted of sixteen children with adenoid hypertrophy and perennial allergic rhinitis. In this group we examined the influence of medical treatment (topical nasal steroid and antihistaminic) on the adenoid size and rhinometric curve. The third group consisted of twelve birch pollen-sensitive children who had symptoms of seasonal allergic rhinitis. In this group we examined the influence of pollination on the nasopharyngeal period of rhinometric curve. RESULTS: In the two first groups we observed a significant increase of the nasopharyngeal cavity after surgical removal of the adenoids and medical treatment of the allergy. In the third group most of the children experienced a significant decrease in nasopharyngeal cavity volume during pollination. CONCLUSIONS: Acoustic rhinometry seems to be a very promising method of assessment of the amount of adenoid, and allergy can play an important role in adenoid hypertrophy in hypersensitive children.
Asunto(s)
Tonsila Faríngea/patología , Alérgenos/efectos adversos , Rinometría Acústica/métodos , Adenoidectomía , Tonsila Faríngea/efectos de los fármacos , Tonsila Faríngea/cirugía , Betula , Niño , Preescolar , Endoscopía , Estudios de Evaluación como Asunto , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Hipertrofia/tratamiento farmacológico , Hipertrofia/etiología , Hipertrofia/patología , Hipertrofia/cirugía , Nasofaringe/patología , Polen/efectos adversos , Rinitis Alérgica Estacional/tratamiento farmacológico , Rinitis Alérgica Estacional/etiología , Rinitis Alérgica Estacional/patología , Esteroides/uso terapéuticoRESUMEN
The role of enlarged adenoids and tonsils in upper airway obstruction has become well-established earlier, thus, adenoidectomy with or without tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population. Direct assessment of adenoidal size is difficult and no definitive method is so far available to complement clinical assessment. The most important diagnostic techniques are recording of obstructive symptoms, transoral posterior rhinoscopic examination, radiological evaluation, such as lateral radiography of the adenoid and nasopharyngeal magnetic resonance imaging, transnasal fiberoscopic examination, acoustic rhinometry and others. In this study we compare acoustic rhinometry, fiberoscopy and Cohen and Konac radiological method. Spearman's correlation test was used to evaluate the degree of correlation between these three methods. We concluded that acoustic rhinometry and radiology are good and objective methods for measuring adenoid sizes in allergic children.
Asunto(s)
Tonsila Faríngea/patología , Rinitis Alérgica Perenne/diagnóstico , Niño , Preescolar , Diagnóstico Diferencial , Endoscopía , Femenino , Humanos , Hipertrofia/diagnóstico , Imagen por Resonancia Magnética , Masculino , Tonsila Palatina/patología , Rinitis Alérgica Perenne/patología , Rinometría AcústicaRESUMEN
The diagnosis of food allergy is difficult because it is a multifaceted problem and is incompletely understood. Both upper and lower respiratory tracts can be affected by food allergy. The importance of bacterial allergy of the upper respiratory tract is however one of the most controversial problems in allergology. The palatine tonsils play an important role in immunologic surveillance and resistance to infection in the upper aerodigestive tract. The role of enlarged adenoids and tonsils in upper airway obstruction has become well-established earlier, thus, adenoidectomy with, or without, tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population. Research done in respect to Waldeyer's ring on people dealing at the same time with allergy, is seldom the subject of dissertation in Polish as well as world wide medical literature. To examine the influence of food and bacterial allergy on the tonsilar hypertrophy (TH) we studied 136 children ages 3 to 7 years, who had TH. On the basis of allergic and immunological examinations, in 28.6% food allergy was confirmed as the main cause of the complaints. We conclude that large tonsillar tissues sometimes with upper airway obstruction may by caused or aggravated by food allergies, therefore, early prevention of exposure to them may help reduce occurence of TH.
Asunto(s)
Bacterias/inmunología , Hipersensibilidad a los Alimentos/epidemiología , Hipersensibilidad/epidemiología , Hipersensibilidad/inmunología , Tonsila Palatina/patología , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Femenino , Hipersensibilidad a los Alimentos/inmunología , Humanos , Hipertrofia/epidemiología , Hipertrofia/patología , Hipertrofia/cirugía , Inmunoglobulina E/inmunología , Incidencia , Masculino , Tonsila Palatina/cirugía , TonsilectomíaRESUMEN
Tonsils and adenoid are part of Waldeyer's ring, the basic function of which is antibody formation, they react later against a great variety of antigens. The role of enlarged adenoids and tonsils in upper airway obstruction has become well-established earlier, thus, adenoidectomy with, or without, tonsillectomy is one of the most commonly performed surgical procedures in the paediatric population. Research done in respect to Waldeyer's ring on people dealing at the same time with allergy, is seldom the subject of dissertation in polish as well as world wide medical literature. To examine the influence of atopy on the adenoid hypertrophy we studied 115 children ages 4 to 9 years, with an average age of 5.9 who had allergic rhinitis asthma or atopic dermatitis. The study suggested that allergic rhinitis is an important risk factor for an adenoid hypertrophy (AH) in children, therefore, early prevention of exposure to them may help reduce occurrence of AH.
Asunto(s)
Tonsila Faríngea/patología , Hipersensibilidad/complicaciones , Tonsila Faríngea/cirugía , Niño , Preescolar , Femenino , Humanos , Hipertrofia/complicaciones , Hipertrofia/patología , Hipertrofia/cirugía , MasculinoRESUMEN
Tonsils and the adenoid are part of Waldeyer's ring, the basic function of which is antibody formation, they react later against a great variety of antigens. Tonsillectomy and adenoidectomy procedures are among the oldest surgical procedures still performed today. The different immunoglobulin serum levels in patients having undergone extirpation of the tonsils, adenoids or both, have been studied before and after surgery by different authors, with discordant results. Immunoglobulin E (IgE) is important in allergic reactions and host defense against parasites. In this study we measured serum levels of immunoglobulin E before and 3 months after tonsillotomy, adenoidectomy, and adenotonsillectomy. There were statistically significant differences between pre and post-operative levels of serum IgE, which decreased after tonsillotomy, but we have not noticed any statistically significant differences in the IgE values after adenoidectomy and adenoidotonsillotomy with respect to those prior to surgery.
Asunto(s)
Adenoidectomía/métodos , Tonsila Faríngea/inmunología , Tonsila Faríngea/cirugía , Hipersensibilidad/sangre , Hipersensibilidad/inmunología , Inmunoglobulina E/sangre , Tonsila Palatina/inmunología , Tonsila Palatina/cirugía , Tonsilectomía/métodos , Adolescente , Adulto , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Hipersensibilidad/etiología , MasculinoRESUMEN
Allergic sensitisation of the airways occurs in the mucosa of the shock organ, or in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid and tonsils. Research done in respect to Waldeyer's ring on people dealing at the same time with allergy, is seldom the subject of dissertation in polish as well as world wide medical literature. In the enclosed dissertation, writers present the results of histopathological and immunohistochemical analysis of hyperplastic tonsils and adenoid, taken from children with coexisting atopy. The authors describe an immunohistochemical analyses of the hyperplastic human palatine tonsil. They present the expression of antigen CD3, CD20, CD45, CD68, EMA, SMA, Vimentin, Desmin, S-100, von Willebrand Factor, p35, Bcl-2, melanin, cytokeratin, estrogen receptor, progesteron receptor, kolagen IV and NSE in every region of pallatine tonsil. It is worthwhile to remark, that many of these cases, the presence of eosinophilia and subepithelial oedema was observed. Our immunohistochemical findings support the hypothesis that allergic sensitization takes place in the adenoid and tonsils. Furthermore, this study confirms that dendritic cells ad macrophages are involved and important in allergic disease.