ABSTRACT
Drug and food allergy in 80% of cases are the cause of duodenal inflammation disrupting the function of the pancreatic ducts. However, in some cases, elimination diet in patients with food allergy does not provide a sufficient effect. The article shows the effect of cross-allergic reactions on recurrent pancreatitis in 28 children with food allergy (mean age 11.7 +/- 2.9 years). As an additional diagnostic criterion the coefficient of degranulation of mast cell in the intestinal mucosa (the ratio of degranulated forms to granulated) was determined, through which the effect of cross-allergic reactions (between food antigens and drugs of animal origin) on the duration and frequency of exacerbations of chronic pancreatitis in children with food sensitization has been shown. The exception of enzyme preparations for children with sensitization to pork and exception of eubiotics prepared using sucrose-gelatin-milk medium for children with sensitization to cow's milk and beef led to feel better in a shorter time (2-3 days) and to reduce the frequency of relapses. Catamnesis observation for 3 years showed that the incidence of recurrent exacerbations of the disease in 11 children with excepted cross-allergic reactions in the first year of follow-up was 9.1%, in the second year--9.1% and in the third year--0%, while in control group (17 children) the frequency of exacerbations was respectively 23.5; 35.3; 35.3%. In patients of the main group there was a slight overall increase of mast cells in the intestinal mucosa from 211.7 to 230.2 mm2 (p > 0.05) with decreasing of degranulated forms from 163.6 to 138.71 mm2 (p > 0.05) and significant increase of granulated forms from 47.41 to 91.51 mm2 (p < 0.05), resulting in a significant decrease in mast cells degranulation coefficient from 3.2 +/- 0.62/mm2 to 1.24 +/- 0.26/mm2 (p < 0.0001). Thus, duodenal etiology of recurrent pancreatitis caused by exposure to food antigens or cross-allergic reactions can be diagnosed with an additional diagnostic criterion--the coefficient of mast cell degranulation, whose exponents greater than 1.5 indicate evidence of antigenic exposure to the mucosa of the duodenum and allergic inflammation.
Subject(s)
Allergens , Food Hypersensitivity , Pancreatitis , Adolescent , Allergens/adverse effects , Allergens/immunology , Child , Cross Reactions , Female , Follow-Up Studies , Food Hypersensitivity/blood , Food Hypersensitivity/complications , Food Hypersensitivity/immunology , Food Hypersensitivity/pathology , Humans , Male , Pancreatitis/blood , Pancreatitis/etiology , Pancreatitis/immunology , Pancreatitis/pathologyABSTRACT
The article discusses the methods of diagnosis and surgical treatment of intussusception of the intestine in children according to the stages of the disease. Colonoscopy is recommended for wide use; it helps in making the precise diagnosis in an atypical clinical picture of intussusception in the early periods, revealing the indications for operative treatment, and determining the volume of the intervention on basis of objective control of the degree of injury suffered by the strangulated intestine.
