Сборник тезисов XXII Конгресса педиатров России с международным участием «Актуальные проблемы педиатрии». Москва, 21–23 февраля 2020 г.
Food allergy is often the first manifestation of allergy in a child, and this problem is most relevant at an early age. With an allergic reaction to food, a seemingly not very significant pathology, a so-called «atopic march» may begin with the development of severe forms of allergic diseases in a child. At the same time, a favourable course of food allergy is possible with the disappearance of disorder signs with age. The disease prognosis depends on many factors, both genetic and environmental, but early diagnosis and adequate treatment of children with food allergies in most cases allow to improve the prognosis of tolerance formation or, at least, to achieve a mild course of food allergy manifestations. It is pediatricians who first deal with early manifestations of food allergies, and adherence to clinical guidelines for managing patients avoids the most common mistakes. This article is addressed to practicing doctors. It considers the most common mistakes of pediatricians in the management of children with food allergies and discusses the surviving «myths» about this pathology.
An increase in the prevalence of diseases resulting from disorders of metabolism and immune system functions is largely due to disturbances in the intestinal microbiota composition at an early age. The review considers the stages and conditions of the natural development of the intestinal microbiota, starting from the intrauterine period. We conducted the analysis of possible risk factors for the intestinal microbiota composition disorders in the pre- and postnatal periods. The results of modern studies on the association between the intestinal microbiota composition in infancy and the development of «civilization diseases» at older ages are given. A separate section is devoted to a discussion of the efficacy and appropriateness of taking probiotic drugs for disease prevention.
Homocystinuria is a genetically heterogeneous hereditary disease from the group of aminoacidopathies caused by a metabolic disorder of sulphur-containing amino acids, primarily methionine. The article presents the etiopathogenetic, diagnostic and therapeutic aspects of this disease and covers modern opportunities of biochemical and molecular diagnostics. The approach to dietary and pharmacological correction of metabolic disorders in homocystinuria and the general strategy of patients’ management are described in detail. Important information is given for physicians of various disciplines and parents of patients.
We present a case of late detection and course of the primary tuberculosis complex in a child who was previously in an unknown contact with a tuberculosis patient at the first year of life. The disease onset simulating pneumonia took place at the age of 1 year 8 months. Hereafter, the child did not have any clinical signs of the disease. At the age of 5 years, the child was examined in connection with the hyperergic reaction to tuberculin: the results of computed tomography revealed calcinated foci in the lung tissue and calcifications in the intrathoracic lymph nodes; bronchoscopy revealed infiltrative bronchial tuberculosis. Surgery was performed: video-assisted thoracoscopy, resection of C9,10 part of the left lung with precision removal of the focus in its C6 segment, extirpation of bifurcation, and left bronchopulmonary lymph nodes. The results of the histological examination indicated the chronic course of the tuberculosis process with formation of bronchiectasis and presence of bronchonodular fistulas. After surgery and the main course of antituberculous therapy, a clinical cure with small residual changes was achieved.
