Vol 15, No 2 (2018)

Background. To estimate the frequency of fungal sensitization and allergic bronchopulmonary aspergillosis in patients with asthma or cystic fibrosis. Methods. The study included 205 patients with asthma and 190 patients with cystic fibrosis. For detection of fungal sensitization specific IgE antibodies in the blood serum with «AllergoELISA-specific IgE» test system and biotinylated fungal allergens were determined. Mycological examination included microscopy and cultural study of respiratory biomaterials. According to the indications, a CAT scan of the chest was performed. Results. The incidence of fungal sensitization in patients with asthma was 35,6%, CI [29,1%; 42,6%], in patients with cystic fibrosis - 56,8% [49,5%; 64%]. In patients with severe asthma the main fungal allergens were Alternaria spp. (70%) and Aspergillus spp. (60%); in patients with cystic fibrosis: Candida spp. - 73%, Alternaria spp. - 34%, Aspergillus spp. - 27%. The incidence of allergic bronchopulmonary aspergillosis (ABPA) in patients with asthma was 5,3%, in patients with cystic fibrosis - 5,7%. Conclusion Early detection of ABPA in patients with asthma and cystic fibrosis is very important as it changes the therapeutic measures of patients’ management and prevents progression of bronchiectasis and respiratory failure. Determination of specific Aspergillus spp. IgE antibodies in vitro is a necessary stage of diagnosis of ABPA in patients at risk.

Substitution with normal human immunoglobulin is a golden standard of primary immunodeficiencies therapy. Subcutaneous immunoglobulins, especially delivered via «rpid push» method are gaining popularity among patients and treating physician since at home infusions allow to reduce treatment costs and increase patients’ quality of life. Here we report first Russian experience of subcutaneous infusion of Gamunex®-C immunoglobulin, in four patients with primary immunodeficiencies, performed by their parents via «rapid push» method at home. No systemic reactions have been reported, Gamunex®-C treatment prevented severe infections and allowed adequate average serum IgG levels (10,1 g/l while on subcutaneous infusions in comparison with 8,5 g/l while on intravenous immunoglobulin).

Levocetirizine is an effective Hj-blocker in complex treatment of various allergic patients. Allergic rhinitis is often part of a systemic allergic inflammation associated with other allergic diseases, therefore systemic antihistamines are the drugs of choice in it’s treatment.

Today allergic rhinitis is one of the most widespread diseases of a cavity of a nose. Irrigational therapy promotes considerable reduction of allergens at surfaces of a mucous membrane of upper airways and leads consumption of medicines at reduction in patients with allergic rhinitis.