CLINICAL CHARACTERISTICS OF PATIENTS WITH SEASONAL ALLERGIC RHINOCONJUNCTIVITIS (SARK). ANAMNESTIC DATA AND THE STRUCTURE OF COMORBIDITY

Abstract

Introduction. Seasonal allergic rhinitis is AZ of mucous membranes (primarily the conjunctiva of the eye and nasal mucosa), due to hypersensitivity to aerosol allergens of plant pollen and fungi spores, the concentration of which in the air periodically becomes prijenosnog. The leading clinical manifestation of SAR is considered as allergic conjunctivitis. According to statistics, about 70-90% of patients with SAR develops Pulawy conjunctivitis, characterized by itching of eyes, eyelids, their redness, photophobia, lacrimation. Clinically important is the combination of SAR and conjunctivitis. Although the SAR attention usually emphasize on nasal symptoms, more than 80% of patients, as practice shows, suffer from symptoms from the eyes. According to the European and North American researchers, more than 70% of patients with SAR suffer from eye and nasal symptoms, and their severity the majority of patients assessed asmoderate or severe.Materials and methods. Clinical and anamnestic study was done in 120 patients aged from 19 to 45 years. All the studied patients were divided according to the degree of severity of the disease: 58 patients with moderate course of seasonal allergic rhinitis and conjunctivitis (EYE), which caused Pilica ambrosia and 62 patients with severe SARK, which pilca caused by ragweed. Of these, 43 (35,8%) women, 77 (64.1%) of men aged 19 to 25 years – 76 (63.3 per cent), from 25 to 45 years – 44 (36.6%) patients. The control group consisted of 30 healthy people.Research results. The differentiation of the history of infectious diseases patients. In the studied patients SARK with moderate current, acute respiratory illness (ARI) was observed in 54 (26,9%) patients, varicella – 16 (8,0%), mumps – 12 (6,0%), measles in 11 (5,5%), viral hepatitis in 4 (1,9%) patients, acute bronchitis 36 (17,9%), pneumonia – 17 (8,5%), the scarlet fever in 6 (2.9%) and intestinal infection in 7 (3,5%), sore throat – 25 (12,4%), otitis in 13 (6,5%) patients. In patients with severe SARK, ARI was observed in 59 (23,3%) patients, varicella – 24 (9,5%), mumps – in 18 (7.1 percent), measles – in 16 (6.3 percent), viral hepatitis in 7 (2.8%) and acute bronchitis – in 43 (17%), pneumonia in 19 (7,5%), scarlet fever in 8 (3,2%), intestinal infection in 9 (3,6%), angina 32 (12,6%), otitis media – in 18 (7.1 per cent) patients.Analyzing the structure of infectious diseases in the anamnesis in the studied patients SARK need to emphasize that their structure is dominated infection in the upper respiratory tract and broncho-pulmonary system that leads to depletion of nonspecific and specific immunity factors, formation of secondary immunodeficiency in these systems.Discussion of research. In the study of biochemical parameters of blood in patients with SARK in the period of aggravation established that the greatest changes are observed from endogenous cholesterol and phospholipids, which may indicate the failure of the macrophage link of immunity. At the same time, β-lipoproteins and NIK was increased only in the group of patients with severe SARK. The increase of phospholipids in serum of patients with severe SARK can point to the implementation of late phase allergic inflammation in cellular tissue structure of the nasal mucosa.Conclusions. Conducted research of history data, the structure of comorbidity, laboratory parameters allergological studies have shown that SARK is formed on the background of progressive sensitization and allergization of the organism, which is implemented in the manifestation of allergic reactions, forming the severity of SARK, and on the strength of the immune response to a variety of ecoalign that define the types of immunopathological reactions in this cohort of patients.