Allergic cough at children – protective reaction of an organism to hit of anti-genes in airways with the subsequent formation of hypersensitivity and development of a specific clinical picture. Allergic cough has pristupoobrazny character, can be dry or with allocation of a small amount of a transparent phlegm, sometimes is followed by a bronchospasm and other symptoms of an allergy (sneezing, cold, dacryagogue). Diagnostics demands consultation of the children's allergist or the pulmonologist, carrying out spirometry, . Treatment means elimination of contact with anti-genes, use antihistaminic, resolvents, ASIT.
Allergic cough at children
Allergic cough at children – one of allergy symptoms arising against the background of an inflammation and hypostasis of tissues of bronchial tubes, a trachea, a throat. Has unproductive, pristupoobrazny character. It is formed as at the sharp, and chronic course of inflammatory reaction. Accompanies such diseases as allergic laryngitis, tracheitis, bronchitis, bronchial asthma and others. Now increase of frequency of allergic pathologies among children is observed worldwide. About 10-12% of children's population suffer from any type of an atopiya, primary detection of a disease happens aged from 5 up to 12 years. Children up to three years practically do not suffer from the above-stated pathologies.
The reasons of allergic cough at children
Not microbic anti-genes getting into an organism together with the inhaled air from the outside or the infectious pathogens parasitizing in an organism act as the Etiologichesky factors provoking kashlevy an attack. At the same time for development of allergic reaction such conditions as anti-gene load of an organism and a condition of immune system at the child have the greatest value. The most significant reasons can be divided into three groups:
- Inhalation of allergens and pollyutant. The leading etiopatogenetichesky factor of allergic cough is receipt of anti-genes in airways in the course of breath. Parts of house dust, wool or feathers of pets, pollen of plants, aerosol chemicals act as allergens. Thus respiratory allergoza are formed: pharyngitis, laryngitis, , bronchitis, bronchial asthma.
- Fungal damages of airways. Penetration of barmy and mold mushrooms (an aspergilla, Candida, penicillia, , an alternariya) or their dispute in a gleam of a throat, bronchial tubes leads to emergence of an infectious and/or allergic inflammation. Development of deep mycoses (fungal pharyngitis, laryngitis) is promoted by imperfect immunity at small children, adverse living conditions: emergence of a mold on walls, dampness.
- Parasitic invasions. At helminthoses (an askaridoza, toxoplasmosis, a toksokaroza) and protozoan infections (an amebiaza, a lyamblioza) cough results not from direct hit of anti-genes in airways, and owing to the general allergization of an organism (increase in the IgE level, an eozinofiliya, emission of mediators of an inflammation). On this background at children with an atopiya other allergic manifestations including respiratory quite often escalate: there are persistent kashlevy paroxysms, bronkhospastichesky reactions.
The current of a kashlevy syndrome is influenced by nonspecific trigger factors which in itself do not cause allergic reaction, but promote its formation. Not coordinated work of immune system at children's age, heredity, passive or active (independent) smoking, a chronic bacterial inflammation of departments of respiratory system are considered as those.
Development of cough of allergic genesis is more caused by the reaginovy (IgE-mediated) type of damage of fabrics in which basophiles, corpulent cages, eosinophils participate. The similar type of allergic reaction is called hypersensitivity of immediate type. The pathogenesis can be divided into three phases conditionally. In an immunological phase there is an interaction of allergen to macrophages and attraction of V-lymphocytes which in the subsequent develop IgE-antibodies. The last, in turn, circulating in the general blood-groove, settle on corpulent cages and are in an inactive state.
The Patokhimichesky phase begins with the moment of repeated hit of allergen in an organism. At the same time corpulent cages are degranulated, that is throw out in blood mediators of an inflammation of the first order (a histamine, a triptaz) and the second order (leykotriyena, prostaglandins). In a pathophysiological phase the sokratimost of bronchial gladkomyshechny fabric increases, slime hyperproduction, infiltration and injury of a mucous membrane is observed. Against the background of irritation and an active inflammation the reflex answer in the form of cough appears.
Symptoms of allergic cough at children
Cough at an allergy usually unproductive, pristupoobrazny, barking, rough, does not pass for several weeks or months. The phlegm ‒ transparent, nonviscous, without impurity of pus or blood is sometimes allocated. There are no symptoms of intoxication, body temperature does not increase, the fever does not disturb. Cough can be the only display of an allergy or is combined with such symptoms as cold, sneezing, an itch of mucous. At long long cough pains in a thorax because of an overstrain of skeletal muscles are possible, they pass in rest independently. At accession of allergic conjunctivitis the clinic is supplemented with reddening, hypostasis of tissues of eyes, lachrymation.
The nature of allergic cough depends on type of the main disease. At bronchial asthma it develops against the background of a bronchospasm, is followed by difficulty of an exhalation, disturbs mainly at night or when awakening the child. Kashleva the attack can arise at physical activity, laughter, crying or influence of tobacco smoke. At the time of an attack the patient breathes through the mouth and tries to accept a sitting position with an emphasis of hands in a table or a seat of a chair since due to use of additional skeletal muscles breath is facilitated. At the end of a kashlevy paroxysm the office of insignificant quantity of a transparent mucous phlegm is possible.
At allergic laryngitis cough dry, barking, is combined with irritation in a throat and a voice osiplost. If the disease progresses, the clinical picture is supplemented with short wind, painful swallowing or feeling of the disturbing lump in a throat, cyanosis of lips and a nasolabial triangle, the weakness caused by a hypoxia of fabrics. At a chronic allergic alveolit cough with allocation of insignificant quantity of a mucous phlegm develops, there is it regardless of time of day. Against the background of a kashlevy attack there can be a headache, increase the arterial pressure or heart rate.
For a toksokaroz, a lyamblioz the obstructive bronchitis which is followed by unproductive cough, the whistling rattles and periodic short wind is characteristic. Because of a sensitization of an organism rash, reddening, an itch of integuments joins. Against the background of an askaridoz in the absence of treatment formation of eozinofilny pneumonia is possible, in that case cough is supplemented with temperature increase of a body, weakness, an indisposition.
The allergic diseases caused by hypersensitivity and which are followed by kashlevy attacks without due treatment can end with serious complications: transition of an acute inflammation to a chronic form with the subsequent formation of the centers of a pneumosclerosis, formation of pulmonary heart against the background of stagnation of blood in a small circle of blood circulation, development of respiratory insufficiency, stenoziruyushchy laryngitis, the asthmatic status. At three last pathologies urgent hospitalization of the child in intensive care unit is required.
During diagnosis collecting complaints, specification of the anamnesis of a disease, the nature of cough, seasonality of emergence of symptoms is of great importance. The doctor (the pediatrician, the children's allergist, the children's pulmonologist) should know precisely duration of a course of an allergy, the scheme of therapy and its duration depends on it. Inspection consists of the following stages:
- Primary consultation. Inspection of the child, percussion and an auskultation of lungs is performed. At asthma or an allergic alveolit the dry whistling rattles amplifying at an exhalation are heard. In the lower departments of lungs the krepitation is possible. At a thorax palpation morbidity is not noted.
- Laboratory diagnostics. In the general blood test the quantity of neutrophils, eosinophils increases, the speed of subsidence of erythrocytes increases. At an immunological research of serum of blood high concentration of IgE, sometimes - IgM and IgG are defined. In a phlegm at asthma eosinophils, crystals of Sharko-Leiden, Kurshman's spiral appear. At an estimated parasitic invasion within search of the reason the analysis a calla is appointed to helminths and protozoa.
- Tool diagnostics. At spirometry reduction of volume of the forced exhalation in one second (OFV1), decrease in the forced vital capacity of lungs (FVCL) is fixed. On a survey X-ray analysis or a computer tomography of OGK at a long fit of coughing and the heavy course of an allergy strengthening of the pulmonary drawing, expansion of vessels of roots of lungs comes to light.
- Allergoproba. At the correct implementation of skin tests it is possible to reveal existence of hyperreactivity in response to use of certain allergens. Allergoproba are appointed since 2 years. To this age implementation of skin tests is possible, but their informational content considerably decreases, there is a probability of obtaining false positive results.
Differential diagnostics should be carried out with other types of cough which are found at acute respiratory viral infections, acute bacterial bronchitis, pneumonia, laryngitis, tracheitis. The barking, convulsive cough - the main symptom of whooping cough, tuberculosis. Cough in combination with frequent breath and sharp development of cyanosis demonstrates hit of a foreign matter in a trachea or bronchial tubes.
Treatment of allergic cough at children
Treatment, as well as prevention, any allergic disease begins with elimination of contact with allergen, otherwise any etiotropny therapy will be inefficient. The scheme of treatment is defined with the course of a disease and features of an organism of the child. The following options of therapy are most often applied:
- Antiallergic therapy. Antihistaminic medicines block histamine receptors and by that eliminate the inflammatory reaction caused by the mediator of the same name. Medicines of the second and third generation have the bigger duration of action and practically do not cause drowsiness.
- Inhalation therapy by glucocorticosteroids. GKS in short terms eliminate an inflammation, production of slime, remove hypostasis of fabrics and increase a gleam of bronchial tubes. Are used for treatment of bronchial asthma, knocking over of a kashlevy attack. The dosage is selected taking into account age, the frequency of exacerbations of allergic pathology.
- Expectorant means. Have symptomatic effect as do not work on , but reduce expressiveness and duration of cough. Fluidifying of slime and strengthening of its removal improves passability of airways.
- ASIT. The allergenspetsifichesky immunotherapy (ASIT) is considered the special direction of treatment of allergic diseases. It includes oral or injection introduction of small doses of allergens with gradual increase in concentration of an active component. In pediatrics and allergology in such a way try to obtain formation of resistance of an organism to an anti-gene and elimination of respiratory allergoz. ASIT begin to carry out since five years.
At identification of a parasitic invasion consultation of the children's infectiologist then antiparasitic means are appointed is required. Preference is given to the universal medicines destroying a big range of activators, thus, it is possible to avoid a combination from several medicines and to reduce risk of development of side effects.
Forecast and prevention
At observance of recommendations of the children's allergist and elimination of a source of an allergization the forecast favorable, the risk of development of negative consequences is minimum. Prevention of allergic cough consists in creation around the child of the hypoallergenic environment, timely treatment of associated diseases, improvement of living conditions. It is undesirable to store books on open shelves and to carpet floors as it is the main sources of household dust. It is necessary to minimize quantity of plush, textile toys at children, to buy the plastic or rubber products which are not exhaling chemical smells.