Вопросы современной педиатрии (Jul 2018)
A CASE OF THE EARLY DEVELOPMENT OF ATOPIC DERMATITIS IN A NURSING INFANT
Abstract
Background. The early (in the first months of life) formation of atopic status and the development of allergies are not uncommon pathological conditions in a pediatrician's practice, requiring sufficiently studied and theoretically grounded measures for the organization of primary/secondary prevention.Case Report. The parents visited a doctor with complaints of widespread skin rashes and troubled night sleep in a child from the age of two months. A burdened history of allergies of the child was traced through the female lineage (food allergy in the mother, maternal sister and grandmother). The perinatal period is complicated by acute respiratory infection in the third trimester and by maternal nutritional preferences (consumption of goat's and whole cow's milk). The delayed (on the 5th day of life) breastfeeding initiation, feeding with cow's milk-based formula, living next to an industrial enterprise, maternal choices of products with a high sensitizing potential not only during pregnancy but also during breastfeeding probably caused the early formation of atopic status — dry skin, widespread papular rash, microvesicles on the cheeks, hips, shins, scratching traces, serous-bloody crusts objectively defined at admission. The SCORAD scores corresponded to severe atopic dermatitis. The ImmunoCAP technology revealed high antibody titres to a number of products, including cow's milk and chicken egg proteins. Based on the findings, a therapeutic diet aimed at secondary prevention of allergic diseases, including respiratory allergies, was developed for the child.Conclusion. A case of the early (from 2 months) formation of atopic status with the development of atopic dermatitis caused by polyvalent food sensitization is described. A therapeutic diet containing products with a low sensitizing potential was prescribed for the child. The suggested therapy including the diet should prevent the progression of an allergic disease.
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