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Child Atopic Disease


Paediatric Clinic, Risk Identification, and Management of Child Atopic Disease

The worldwide prevalence of allergy ranges from 30-40% and it has been a significant increase during the last few decades. The most allergic disorder is mediated by IgE and target organs are lungs, skin, GIT, nose. This surge is due to changes in environment factor(tobacco smoke, pollution, respiratory viruses, obesity). And maybe a decline in certain infectious diseases(hygiene hypothesis). Allergic rhinitis(AR), Asthma and atopic dermatitis are the most common allergic disorders.
History, physical examination, and diagnostic assessment are the cornerstone of the diagnosis and management of atopy. The two main allergy tests are skin test and serum specific IgE level testing(RAST, MAST, CAP.)

Morbidity Preventive Vaccination Clinic For Atopic Child

Children with a chronic pulmonary disease like asthma are at increased risk of infection with higher severity. These atopic children should be taken certain category 3 and category 4 vaccine like influenza, pneumococcal vaccine. It is important to stress the role of influenza, pneumococcal vaccine in those with asthma. The infection rate of influenza are highest in 5-9 years and complication, mortality is greatest in less than 2 years age with asthma. Children 6months to less than 9 years age are given two doses 1 month apart, only one dose is sufficient for more than 9 years of age. The burden of pneumococcal disease is high in India and it is the greatest among the underprivileged children. Children with a chronic pulmonary disease, asthma on high dose oral steroid are at high risk for the pneumococcal disease.

Clinic For Newer Therapies

When an atopic child not responding to traditional treatment then newer therapies are considered with histamine dihydrochloride coupled with human gamma globulin.
Probiotics have been shown to reduce the incidence of atopic disease with the use of Lactobacillus rhamnosus strain GG. The pronounced treatment response has been found in the patient with a positive skin prick test.

Courtesy : Dr. Subir Pal