EXUDATIVE AND CATARRAL DIATHESIS (lat. exsudare to come to light, to be allocated; Greek katarrhoos plaint, expiration; diathesis; synonym atopic diathesis) — anomaly of the constitution, one on the most common forms of diathesis.
The term «exudative and catarral diathesis» is entered in 1905. A. Cherni. The significant contribution to studying of a problem was made by M. S. Maslov, G. N. Speransky, Yu. F. Dombrovskaya, V. A. Tabolin, etc. At the heart of E. - to., by G. N. Speransky's definition, lies hereditary readiness, tendency of an organism to long inflammatory processes and development of allergic reactions.
At children with E. - to. are noted changes of reactivity (see. Reactivity of an organism ) in the form of inadequacy of skin and vascular reactions» changes of permeability of membranes, disturbances of amino-acid exchange, functional insufficiency of system of cyclic adenosinemonophosphate, cytochemical changes; disturbances of exchange tryptophane (see) and pyridoxine (see), sensitization of fabrics to to a histamine (see) and to acetylcholine (see). At E. - to. is often observed hereditarily the caused ability to produce the increased amount of immunoglobulins B (reagins) that in case of contact with allergens is the reason of allergic reactions of immediate type (see. Allergy ), biologically active agents which are followed by release — a histamine, serotonin (see), slowly reactant of an allergy, etc. Quite often decrease in level of T-kletok-supressorov, decrease in content of secretory immunoglobulins A comes to light (see. Immunoglobulins ). The role of food-borne allergens is especially big at children of the first year of life in connection with their transfer during this period into artificial feeding (see). At the same time also age immaturity of the alimentary system of the child, its insufficient secretory activity, sometimes — enzymatic insufficiency is of great importance. Food allergy (see) promotes a sensitization of an organism and to other allergens. Cancellation of a food-borne allergen at early stages of process can bring to a wedge, to improvement and delay of progressing sensitization (see).
The earliest manifestations E. - to. are round yellowish spots on a front surface of shins (Meyergofer's spot), and also yellow or brown scales on a pilar part of the head (gneiss), to-rye later removal appear again. From first months of life at children persistent are observed intertrigo (see), a milk scab — limited erubescence of cheeks with a thickening of epidermis and a scaly peeling, tendency to exfoliating of an epithelium — «geographical language» (see. Glossitis ). At influence of allergens, is more often food, at children develops eczema (see), at advanced age — neurodermatitis (see), a prurigo (see). Children are inclined to development of false grain (see), asthmatic bronchitis (see), to a long current pneumonia (see) and diseases went. - kish. path. In cases of early displays of exudative and catarral diathesis at children further are often observed bronchial asthma (see), pollinosis (see), medicinal allergy (see).
At E. - to. is necessary individual approach to artificial feeding. Use acid dairy products (see. Lactic products ) — the kefir, a yogurt, the mixes «Baby» and «Vitalakt» acidified by dry ferment. In hard cases dairy products exclude completely, enter vegetable purees into a diet; porridges are recommended to be cooked on vegetable broths. Broths, ku riny meat are prohibited. The yolk should be given hard-boiled. New types of food enter into a diet of the child with care. Appoint digestive enzymes (abomin, panzinorm, etc.), at disturbances of exchange of tryptophane — a pyridoxine, at insufficiency of lactase — a delactosed diet (see. Malabsorption syndrome ). At emergence E. - to. at the child receiving maternal breast milk (see), it is not necessary to refuse breastfeeding, however on food of mother it is necessary to exclude the products which are allergens (fish, chocolate, a citrus, strawberry, etc.). For reduction of reaction to breast milk in 15 min. prior to feeding the child should give 5 — 10 drops of the decanted milk.
To children with E. - to. are necessary a careful gigabyte. care of skin, the rational, corresponding to weather clothes, sufficient stay on air. It is necessary to avoid contacts of such children with inf. patients. Treatment by pharmaceuticals, especially antibiotics, shall be carried out with care and is strict according to indications.
Children with E. - to. shall be under dispensary observation in children's policlinics. The issue of creation of a calendar of inoculations is resolved individually after consultation with the allergist. It is necessary to apply the sparing methods vaccination (see).
See also Diathesis .
Bibliography: Ado A. D. General allergology, M., 1978; Allergic diseases at children, under the editorship of M. Ya. Studenikin and T. S. Sokolova, M., 1971; The Allergy in pathology of the childhood, under the editorship of G. N. Speransky, page 11, M., 1969; The Multivolume guide to pediatrics, under the editorship of Yu. F. Dombrovskaya, t. 1, page 471, M., 1960; Sokolova T. S., Luz L. V. and Roshal N. I. Food allergy at children, L., 1977; Tabolin V. A., etc. About exchange of tryptophane at the children sick with bronchial asthma. Pediatrics, No. 7, page 43, 1974.
T. S. Sokolova.