Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press28710.36691/RJA287ArticlesСтатьиReview ArticleCONFIRMATION OF ETIOLOGIC DIAGNOSIS IN CHILDREN WITH HOUSE DUST MITE ALLERGY AS AN ESSENTIAL STAGE BEFORE ALLERGEN SPECIFIC IMMUNOTHERAPY. A REVIEWПОДТВЕРЖДЕНИЕ ЭТИОЛОГИЧЕСКОГО ДИАГНОЗА У ДЕТЕЙ С АЛЛЕРГИЕЙ НА КЛЕЩЕЙ ДОМАШНЕЙ ПЫЛИ КАК НЕОБХОДИМЫЙ ЭТАП ПРИ ПЛАНИРОВАНИИ КУРСА АЛЛЕРГЕН-СПЕЦИФИЧЕСКОЙ ИММУНОТЕРАПИИ. ОБЗОР ЛИТЕРАТУРЫTrusovaO VТрусоваОльга Валерьевна

доцент кафедры терапии госпитальной с курсом аллергологии им. акад. Черноруцкого с клиникой.

o-tru@mail.ruKamaevA VКамаевА В

доцент кафедры общей врачебной практики (семейной медицины).

LyashenkoN LЛяшенкоН Л

ассистент кафедры общей врачебной практики (семейной медицины).

MakarovaI VМакароваИ В

доцент кафедры терапии госпитальной с курсом аллергологии им. акад. Черноруцкого с клиникой.

FSBEI HE I.P. Pavlov SPbSMU MOH RussiaФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России14122017146NO6 (2017)№6 (2017)9810610032020Copyright ©; 2017, Pharmarus Print MediaCopyright ©; 2017, Фармарус Принт Медиа2017Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/287

House dust mites are important cause for allergic rhinitis, and almost half of allergic rhinitis patients is sensitized to them. In patients with house dust mite allergy evidence of sensitivity can not be strictly achieved with medical history and patients complaints, since the cause-effect relationships are not obvious. At the same time incomplete allergological examination can lead to an incorrect definition of the main relevant allergens, and expensive treatment may not give the desired result in this cases. The estimation of the allergens for allergenspecific immunotherapy should be based on the disease history, detection of offending allergens by means of allergological examination in vivo with skin tests, nasal or conjunctival provocational tests, and component diagnostics if necessary. This approach based on use of provocational tests as a part of allergological examination is considered to be one of the ways to personalized therapy.

Сенсибилизацию к клещам домашней пыли обнаруживают приблизительно у половины больных аллергическим ринитом. Таким образом, клещи домашней пыли - важная причина аллергического ринита. У пациентов с ринитом, вызванным сенсибилизацией к клещам домашней пыли, при сборе анамнеза невозможно получить прямые подтверждения чувствительности, так как причинно-следственные связи контакта с клещами и симптомов не очевидны. Неполное аллергологическое обследование чревато неправильным определением ведущего причинного аллергена у пациента, и по этой причине трудозатратное и дорогостоящее лечение может не дать желаемого результата. Выбор аллергена для аллерген-специфической иммунотерапии (АСИТ) должен быть основан на результатах повторного сбора анамнеза после выявления сенсибилизации и дополнительного использования методов определения аллерген-специфического IgE, при возможности компонентной диагностики, а также назальных или конъюнктивальных провокационных проб с аллергенами. В отличие от тестов, направленных на выявление IgE-сенсибилизации, прямые провокационные тесты позволяют сделать обоснованное заключение о наличии или отсутствии причинной роли подозреваемого аллергена и являются одним из способов подбора больному адекватной, персонифицированной терапии.

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