Atopic march: causes, treatment and clinical recommendations

In the article, we consider that this is an atopic march.

Which of the parents did not encounter such a problem as redness and rashes on the cheeks of the baby? And increasingly, diagnoses sounded: diathesis, eczema and the like. However, to date, doctors have come to a common opinion: children do not have eczema, and skin hyperreaction is nothing more than an atopic march, which in everyday life is called allergy.

Definition

Appearing for the first time at an early age, this pathology does not leave the patient all his life. What is this atopic march in children? It is a natural manifestation of the child’s heredity.

Bronchial asthma, dermatitis (allergic), rhinitis (allergic) with conjunctivitis are interrelated diseases in their pathological and morphological foundations and development mechanisms. Starting at an early age with atopic dermatitis, in the future they can transform into each other or combine with each other. That is, we are talking about the same concept, but from different points of application of allergies.

So, this triad of allergic diseases, which are replaced in stages, is an atopic march in children.

In this case, the formation of hypersensitivity to a particular allergen and a change in the clinical form of the manifestation of the disease occur.

It must be remembered that the timely detection of symptoms of atopy in a child and the implementation of therapeutic treatment will prevent the development of a severe form of the disease and stop the progression of the atopic march.

Allergy Mechanisms

Allergies are common today among both children and adults. Studies show that the number of patients with one or another type of allergy is constantly growing.

The leading mechanism of childhood allergies is atopic, or reagin. The synthesis of IgE antibodies that are sensitive to allergens provokes certain reactions in the body.

Atopy - a predisposition to the production of these same IgE antibodies, which is genetically determined. When allergens (usually of a protein nature) are ingested, even in small amounts, an allergic reaction of the body occurs.

What are the causes of the atopic march? An atopic child often at birth has an increased amount of IgE, which is synthesized during fetal development. Often, allergic reactions occur in the first months of his life, as the disease often has a hereditary, "family" character.

In most cases, several allergic diseases are diagnosed simultaneously in one child. For example, in 90% of cases, against the background of allergic rhinitis, bronchial asthma is subsequently formed.

With the atopic march, new types of sensitization are constantly appearing. That is, the process by which the human body produces antibodies in contact with a new allergen.

The first sensitization in the life of a child is food, manifested in the form of atopic dermatitis (most often develops in the first six months after birth).

From the 1st year of life, children have a reaction to allergens from house dust and animal hair. This subsequently leads to the occurrence of conjunctivitis, rhinitis, and if it gets on the skin, exacerbations of atopic dermatitis may occur.

At the age of two, an increase in the incidence of bronchial asthma is diagnosed.

By the age of 5-6 years, the formation of pollen sensitization occurs, the clinical symptoms of which are hay fever, asthma attacks and exacerbation of dermatitis (especially in the summer), a secondary food allergy may occur.

What are the risk factors?

Definitely, all allergic diseases are hereditary. If, for example, hay fever, intolerance to certain types of drugs, bronchial asthma takes place in the family, then children are more likely to suffer from atopic dermatitis. In short, with a genetic predisposition, even the course of pregnancy can be a provocative factor: what did the mother eat, was there a threat of miscarriage, was she taking any medications, and so on. It turns out that, not yet born, the baby is already quite possibly interacting with a potential allergen. Therefore, even when planning a pregnancy, a woman should be safe, and, given the tendency to allergies in the family, try to limit herself in the use of certain products. Naturally, this does not mean a complete rejection of cow's milk, red berries, eggs and nuts, but the norm should be observed.

There are also constitutional features. For example, in chubby children, dermatitis is more severe and spreads faster.

Allergies are also exacerbated, and dermatitis is more pronounced with problems with the intestines.

The problem of our society is the accessibility and unreasonable use of antibiotics, which also lead to a general decrease in immunity and impaired intestinal microflora.

Another scourge of our society is malnutrition. As a result, we have a vicious cycle when one inevitably leads to another, which, in turn, leads to an exacerbation of our diseases. The causes of atopy syndrome and atopic march are important to identify.

Next, find out how and why an ailment occurs in adults. After all, this is also a serious topic.

The causes of the atopic march in adults: skin diseases; reaction to certain foods; hereditary predisposition; stress; exposure to chemical allergens. Atopy of the skin is a pathology that cannot be infected.

Symptoms of the disease

An atopic march is diagnosed if:

1. The skin of the child is red, excessively dry, having a persistent rash, painful itching is felt.
2. Rhinitis and conjunctivitis are seasonal or do not pass throughout the year. There is always a lot of mucus in the stuffy and itchy nose, the baby sneezes, the eyes turn red and tear.
3. There are clear symptoms of asthma: heavy breathing, there are moments of suffocation, persistent cough, bronchospasm. In severe cases of the disease, shortness of breath during physical activity often occurs.
4. In the blood plasma, the concentration of immunoglobulin E is greatly increased, the number of antibodies to various stimuli increases significantly.

Frequently admitted diagnostic errors in this pathology

The following can be attributed here:

1. Denial of atopy with normal IgE levels.
2. The purpose of a diet to cleanse the body of foods that a child may be allergic to only based on a study of the amount of specific IgE (or specific IgG).
3. Unreasonably frequent (more than once a year) tests for the detection of IgE in blood serum.
4. Failure to detect concomitant atopic diseases.
5. Erroneous diagnosis (for example, clinical signs of hypersensitivity to food, pollen allergens appear after direct contact with animals).
6. No burdened heredity for allergic diseases.

Why is it so important not to miss the moment in the treatment of atopic dermatitis at an early age?

By the age of three years without a proper treatment, atopic dermatitis can develop into bronchial asthma, also into allergic rhinitis, and these diseases often hide under the guise of others, such as bronchitis, and children undergo treatment in infectious diseases hospitals. They come to an allergist when asthma has developed.

Complex therapy in the treatment of atopic march

We have already figured out that dermatitis of the same name, allergic rhinitis with conjunctivitis and bronchial asthma are the stages of one pathological process.

If treatment was started in the early stages of the disease, the chances of stopping the disease increase very significantly:

1. The maximum exclusion of exposure to allergens and factors provoking atopic dermatitis. Disease triggers can be any standard food, mechanical, chemical and thermal stimuli characteristic of atopic.
2. Elimination of visible skin reactions: antihistamines are prescribed, due to which the skin is healed, allergy symptoms are reduced; external agents (in the form of ointments) and internal ones are also used.
3. Ensuring hypoallergenic life: a special diet, limiting the child's contact with potential allergens.
4. Timely treatment of chronic infections.
5. Hardening, measures to increase immunity.
6. Maintaining stable remission of existing chronic diseases (gastritis, pancreatitis, etc.)
7. Mandatory control of endocrine pathologies.
8. For the treatment of dermatitis an important role in infancy is the appointment of a certain diet. From the atopic diet, it is necessary to exclude any food that has a high allergenicity indicator (regardless of whether the product is allergenic specifically for your child).
9. If it is impossible to completely exclude the effects of the allergen known to the doctor, ASIT therapy (allergen-specific immunotherapy) can be prescribed. This method consists in the fact that small doses of the irritant are regularly introduced into the body of the child, causing slow weaning from allergens. You can start treatment only from the age of five; it can last up to five years.

Autolymphocytotherapy as a method of treating this pathology

Autolymphocytotherapy is the most effective treatment for the atopic march. It is prescribed to children after five years. This method consists in the fact that a vaccine, which is a mixture of a child’s own lymphocytes obtained from his blood and saline, is subcutaneously injected into the forearm. The dose of the vaccine is gradually increased, the required course consists of 6-8 sessions, the treatment regimen is signed individually.

The effect of therapy does not occur immediately and depends on the individual characteristics of the body.

What are the clinical guidelines for treatment?

Another issue that also worries parents of atopic children. Clinical recommendations for the atopic march are specially developed documents that help the doctor develop the correct treatment regimen for the patient’s pathological condition. They also indicate symptoms, prognosis of the disease and methods for their elimination.

These documents have been used for thousands of years and used in medicine, based on the opinion of the entire period of development of medicine, spanning many millennia, developed based on the opinions of leading experts and evidence-based medicine.

Each doctor needs to know all the clinical recommendations in his segment, but they are still advisory in nature, so the specialist has the opportunity to build an individual approach to the patient.

Clinical recommendations also indicate alternative treatments, which helps to find the most effective method in a short time.

Doctors advice

In the presence of an atopic march in children, clinical recommendations indicate that the disease, as a rule, is allergic in nature. Sometimes it can provoke some kind of psychoemotional shock, some diseases of the internal organs. About 50% of all newborns face this problem in their first year of life.

To avoid the development of the disease in the child, parents need to adhere to basic preventive standards. Allergy-causing foods should have a minimal amount in the baby’s diet (or better to exclude them from the menu altogether).

To make the correct diagnosis, the doctor must:

1. Perform a thorough visual inspection of the lesions.
2. Write out the direction for taking tests.
3. Find out if there are people with allergies in the family.

It is important to understand that the child’s body is much weaker than that of an adult. Therefore, therapy should be as gentle as possible, so as not to aggravate the problem and not harm health.

Not everyone knows how to treat an atopic march. Therapy of this pathology must necessarily include:

1. Changing the diet - it is better to completely exclude highly allergenic foods from the menu.
2. Desensitization - eliminating the body's sensitivity to allergens.
3. Taking antihistamines.
4. Vitamin-mineral complexes - are selected exclusively individually for each patient, since there is a danger of provoking an exacerbation of the disease.
5. Immunomodulators - used to strengthen the immune system and restore the body.
6. Hormone ointment - prescribed for severe forms of the disease, non-hormonal drugs are used in the early stages.
7. Antiviral, antifungal drugs, as well as antibiotics - are used in the presence of a secondary infection.
8. It is recommended to undergo physiotherapy.

Properly selected treatment and strict adherence to the doctor’s recommendations increase the chance to overcome the atopic march in children and adults. Therefore, treat your health very carefully.