In recent years, the incidence of allergic diseases has been increasing year by year due to the development of industrialized society, changes in modern lifestyle and other factors, and the number of children coming to outpatient clinics and wards for allergic diseases has increased significantly. Such diseases have long affected the quality of life of patients and increased the economic burden of families, and have become an important problem for parents and medical personnel.
I. Definition of allergic diseases
Allergic disease refers to a kind of allergen through inhalation, ingestion, injection, contact and other ways to stimulate the body, there is a strong local or systemic reaction, causing a variety of functional disorders or tissue damage.
Second, the main common allergens (allergens).
1, inhalation allergens: dust mites, pollen, fungal spores, animal dander, cockroaches, etc..
2, food allergens: a variety of foods, seafood, fruits, nuts are common (infants and children see more eggs and milk).
3, contact allergens: metals, hair dyes, cosmetics, etc..
4, drug allergens: penicillin, cephalosporins, sulfonamides, insulin, etc..
5, occupational allergens, etc.: formaldehyde, paint, etc.
Third, common allergic diseases.
1, seasonal allergic rhinitis (hay fever), perennial allergic rhinitis, allergic conjunctivitis, etc.
2, allergic asthma, aspirin asthma, allergic bronchopulmonary aspergillosis, allergic bronchitis.
3, acute and chronic urticaria, angioedema, contact dermatitis, atopic dermatitis, hereditary angioedema.
4, drug allergy, food allergy (including oral allergy syndrome, food-dependent exercise-induced allergy), insect allergy, occupational allergy.
5, allergic skin diseases: mainly common eczema (atopic dermatitis), contact dermatitis, etc.
6. anaphylaxis.
Fourth, the diagnosis of allergic diseases
The diagnosis of allergic diseases includes non-specific diagnosis and specific diagnosis.
1.Non-specific diagnosis
Similar to the diagnosis of other diseases, but pay attention to the triggers of onset, seasonality of symptoms (e.g. hay fever has obvious seasonality), regularity (e.g. dust mite allergy has more evening or morning onset); whether there are pets at home; whether there is a history of allergy to a certain food or drug; family history of allergy (allergic diseases are hereditary, if there is a history of allergy in both parents, the probability of the child having allergic diseases is 40%; if both parents have a history of allergy). The risk of the child developing allergic diseases is 60-80%).
2, specific diagnosis, that is, the diagnosis of finding the cause of allergens, is the characteristic of allergic diseases.
It includes two methods: in vivo diagnosis and in vitro diagnosis.
In vivo diagnosis is mainly the skin intradermal test and skin prick test. Precautions.
(1) Before the skin test, ask whether there is a history of serious adverse reactions, whether the current state of allergic reactions, such as the above-mentioned conditions, should not be skin test or prick test, can directly draw blood for in vitro specific IgE detection.
(2) Before the skin test, stop using anti-allergy drugs (e.g. paracetamol, cetirizine, keratan, xanthemin, etc.) and drugs containing anti-allergy drugs for 3 days, and stop taking hormones orally or intravenously for at least 1 week; stop taking tretinoin for 3 days.
(3) People suffering from psoriasis, serious cardiovascular disease should not do skin test.
(4) Patients with a history of needle sickness should not do skin test; blood sampling for IgE can be considered.
(5) The skin test will take 15 minutes to see the result. After the skin test, please wait in the skin test room and do not go far to avoid accidents.
In vitro diagnosis: blood sampling for serum in vitro specific IgE is safe, less painful and accurate. Our pediatric department is now using Uni-CAP100 allergen detector, which is standardized according to the international standard of the World Health Organization (WHO) and recognized by the international academic community of allergic reactions, and is known as the “gold standard” of in vitro allergen detection by experts at home and abroad for its high sensitivity, high specificity and high stability. CAPsystem is currently the best method for in vitro diagnosis. (Note: no fasting is required, only 3ml of venous blood is needed).
Skin testing and in vitro sIgE testing are complementary and not interchangeable, and are important tools for the specific diagnosis of allergic diseases. Only when the clinical history, skin test and in vitro diagnosis are consistent can an accurate and specific diagnosis be made, and the diagnosis of allergens cannot be made on the basis of one or two items alone. Note that both in vivo and in vitro should be considered in conjunction with clinical considerations, and clinical conformity is the only criterion for evaluating the test.
V. Treatment of allergic diseases
Allergic diseases have now become one of the most common chronic diseases, especially in developed countries more prominent. The main purpose of their treatment: first, rapid relief of symptoms; second, prevention of relapse; third, eradication. It is now proposed to advocate: four bodies one comprehensive treatment method (avoidance of allergen exposure, symptomatic drug control of symptoms, standardized desensitization treatment, patient education).