DIATHESIS (grech, diathesis predisposition) — one of forms of reactivity of an organism which is characterized by peculiar reactions to usual irritants, predisposition to these or those diseases and representing set of the hereditary and acquired properties of an organism. The concept «diathesis» is inseparable from the concept «constitution»; M. S. Maslov identifies the concepts «diathesis» and «anomaly of the constitution» (see. Constitution ).
For the first time the term «timiko-lymphatic anomaly of the constitution», or «diathesis», entered the pathologist Paltauf (V. Paltauf) and the pediatrician T. Esherikh in 1896. In 1905. A. Cherni described exudative and catarral D. Boley wide and generalizing it is possible to consider the term «allergic diathesis» offered by A. D. Ado and H. Kammerer. I. P. Lerner offered the term «eosinophilic diathesis», Frontali (G. Frontalis — «the endothelial constitution».
The following most widespread D. allocate: exudative and catarral diathesis (see), limfatiko-hypoplastic diathesis (see), neuroarthritic diathesis (see). On a pathogeny and the wedge, is close to manifestations to neuroarthritic D. so-called urate. The big group is made hemorrhagic diathesis (see). Besides, the mixed forms D.
Exudative and catarral diathesis
In its basis, by G. N. Speransky's definition meet, hereditary readiness, bent of an organism to inflammatory long processes and development of allergic reactions lies.
The Soviet and foreign researchers revealed a number of features and deviations in reactivity of an organism of children with exudative and catarral D.: inadequacy of skin and vascular reactions, anomalies of development of capillaries, hydrolability, disturbance of acid-base equilibrium and amino-acid exchange; change of a ratio of protein fractions and activity of enzymes of blood, decrease in gistaminopektichesky activity, sensitization to a histamine. Disturbance of exchange of tryptophane and a pyridoxine matters. At exudative and catarral D. some inherited can take place enzymopathies (see) which are combined with it.
There are data that persons with exudative and catarral D. have glycoproteins of blood serum and an epithelium of upper respiratory tracts have a similar chemical structure and identical immunol, properties with a carbohydrate part of glycoproteins of some allergens (pollen of plants, horse dandruff). It matters at a sensitization of an organism. At these persons development of allergic reactions is substantially connected with the inherited ability to produce at a meeting with exogenous allergens (food, household, medicinal) special antibodies — the reagins carried to the class IgE (see. Antibodies, allergic ), in this connection develop allergic reaction of immediate type with release of a number of biologically active agents — a histamine, serotonin, MPC-A, etc. and corresponding wedge, symptomatology (bronchial asthma, a small tortoiseshell, a Quincke's edema, an acute anaphylaxis, etc.).
A wedge, ekssudativnokataralny D.'s manifestations can be observed from first months of life. Most often it is skin manifestations (a persistent intertrigo, a milk scab, seborrhea of a pilar part of the head). From mucous membranes — tendency to exfoliating of an epithelium of intestines and urinary tract, it is frequent «geographical language». Is later at action of food-borne allergens and a sensitization of an organism can develop eczema, and at more advanced age — neurodermatitis, a prurigo which are followed by a severe itch. Under the influence of various exogenous allergens and an infection at children the false croup develops, the asthmatic component at respiratory infections, the course of pneumonia accepts long character, there are hron, centers of an infection in a nasopharynx. A number of authors specifies that at the children suffering from exudative and catarral D. further bronchial asthma often develops. At babies the intolerance of milk of mother with development of the dispeptic phenomena is quite often noted.
Limfatiko-gipoplastichesky diathesis is characterized by reduced adaptation of the chromaffin device of adrenal glands to various influences of the environment. Anomalies in development are noted thymus (see) — its relative increase and a delay of involution that affects on immunol, reactivity of an organism of the child (predisposition to development of allergic reactions and processes of an autoaggression is created).
Wedge, manifestations: children of a pastozna, are pale, muscles are developed poorly.
Increase limf, nodes and a hyperplasia of adenoid tissue of nasopharynx is noted. Children are inclined to frequent infectious diseases of upper respiratory tracts. Damages of mucous membranes in the form of nasopharyngites, otitises, a tracheobronchitis, conjunctivitis with a long current are characteristic. In blood the expressed lymphocytosis comes to light. Easily develop stridor (see), asthmatic states; cases of sudden death of children which connect with insufficiency of function of adrenal glands are described. Radiological the delay of involution of a thymus is defined.
Neuroarthritic diathesis is characterized by disbolism: purine, lipidic, carbohydrate.
Wedge, manifestations: at early children's age — tendency to frustration of food and digestion, anorexia (see), the increased nervous irritability. At later age emergence of the vomiting sometimes accepting persistent character as atsetonemichesky is characteristic. Eczema, bronchial asthma, diseases zhelche-and urinary tract develop. This D. contributes to development of obesity, a diabetes mellitus, atherosclerosis, idiopathic hypertensia, gout and exchange arthritises.
Urate diathesis it is characterized by accumulation in biol, liquids uric to - you and its salts. Very often at this D. disturbance of exchange oxalic to - you is noted.
Treatment and prevention
is recommended to Children with exudative and catarral D. breastfeeding, elimination of the allergens promoting a sensitization of an organism of the child, the careful relation to use of antibiotics. Cancellation of preventive inoculations during acute allergic manifestations is recommended; they are carried out by the so-called sparing methods at later age (see. Immunization ).
At limfatiko-hypoplastic D. methods of a hardening are of particular importance and to lay down. physical cultures. It is necessary to observe the same precautionary measures in relation to the sensibilizing influences and preventive inoculations.
At neuroarthritic D. the important place in treatment is taken by a day regimen, exercises, a diet with restriction of fats, eggs, cocoa, and also with an exception of the products rich oxalic to - that and its salts.
At development of allergic diseases carry out the hyposensibilizing and symptomatic therapy.
Bibliography: Ado A. D. General allergology, M., 1970, bibliogr.; Allergic diseases at children, under the editorship of M. Ya. Studenikin and T. S. Sokolova, M., 1971, bibliogr.; B is yar in and V. P. Clinical lectures on pediatrics, M., 1975; To a pathogeny and therapy of a dermatosis at children, under the editorship of Yu. K. Skripkin, page 13, 20, M., 1976; Maslov M. S. Frustration of food and digestion at children of chest age, M. — L., 1928; Miller of and D at to about r P. Biologiya of a thymus gland, the lane with it., M., 1967; The Multivolume guide to pediatrics, under the editorship of Yu. F. Dombrovskaya, t. 1, page 471, M., 1960, bibliogr.; Speransky G. N. and Sokolova T. S. To studying of allergic diseases at early children's age, in book: An allergy in pathology of the childhood, under the editorship of G. N. Speransky, page 11, M., 1969.
V. P. Lebedev, T. S. Sokolova.