Frequency of functional disorders of the biliary tract in children with atopic dermatitis

Abstract

Background. According to the data of numerous authors, the severity of atopic dermatitis (AD) strongly depends on the functional state of the digestive system. The purpose of the study is to analyze frequency and peculiarities of atopic dermatitis course in children with disorders in the biliary system. Materials and methods. A total of 168 children aged 1 to 18 years old with AD were studied. Diagnosis of AD in children was verified according to the diagnostic criteria of J.M. Hanifin and G. Rajka (1980). All patients and their parents were questioned using a survey record. General and specific IgE (pediatric panel) was determined. State of the biliary system was assessed using ultrasonography, biochemical parameters of blood serum. Statistical processing of research results was performed using standard algorithms of variation statistics. Results. According to the questionnaire results, the following risk factors for the development of AD in children and adolescents are found: burdened heredity (53.5 %), allergic manifestations during the 1st year of life (62.5 %), high IgE levels (52.3 %); factors causing exacerbation of AD (triggers): mixed allergens — 23.8 %, food allergens — 71.4 %, medicinal allergens — 17.8 %, household allergens — 5.9 %, pollen allergens — 3.4 %, temperature factor — 1.7 %, psychoemotional factor — 1.7 %, not specified — 24.6 %; artificial feeding from birth (13.1 %); the total duration of manifestation: up to a year — 11.3 %, from 1 to 5 years — 44.9 %, from 5 to 10 years — 23.8 %, more than 10 years — 20.3 %. The mean scoring value for SCORAD in patients with mild AD levels was 14.01 ± 0.63 points, with an average grade of AD of 31.04 ± 0.92 points, and in patients with severe degrees of 56.17 ± 5.23 points. The average score on the EASI scale in the examined patients aged 5 to 7 years was 8.67 ± 0.46 points. The elevated IgE level was registered in 52.3 %. The active survey and observation revealed the signs of functional disorder of the biliary tract in the majority of patients — 109 (64.8 ± 3.2 %) children. The ultrasound examination demonstrated gallbladder dysfunction in 45 (42.8 %) out of 109 children with complaints. Increase liver (up to 10 %) without changes in echostructure and echogenicity was observed in 26 (23.8 ± 0.8 %) children with AD. Conclusions. Given a high frequency of functional disorders of the biliary tract in children with AD, it is recommended to perform an ultrasound examination of the hepatobiliary system and to make the appropriate correction of the revealed violations in the complex treatment of AD on the basis of the obtained data.

Keywords

• children
• atopic dermatitis
• functional disorders of the biliary tract