SOVREMENNAYA PEDIATRIYA.2019.3(99):30-34; doi 10.15574/SP.2019.99.30

Koloskova O. K., Myslytska H. O., Bіlous T. M., Tarnavska S. I.
Bukovinian State Medical University, Chernivtsi, Ukraine

Objective: establish specific clinical and instrumental features of the comorbid flow of asthma with allergic rhinitis (AR) based on the results of longitudinal (for 5 years duration) dynamic observation.

Material and methods. A cohort of 70 patients with bronchial asthma was studied in school-age children, which were divided into two clinical groups depending on the presence or absence of a comorbid flow of allergic pathology. Thus, the first group was formed by 41 patients with bronchial asthma (mean age — 11.01±0.35 years), and the remaining 29 children, whose average age was 11.41±0.3 years, with the comorbidity of asthma from AR entered the second group. The comparison groups were compared according to the basic clinical characteristics.

Results. Analysis of the results revealed the presence of dissonance between clinical and spirographic (according to routine spirography) grade control asthma, which should be considered in view of the progress of comorbid asthma with allergic rhinitis. Course of comorbid asthma and allergic rhinitis is associated with more severe exacerbations of probable risk (OR 1.7–3.3), justifying the appointment of liberal system glucocorticosteroid drugs. Over the course of comorbid asthma and allergic rhinitis a destructive eosinophil-mediated inflammation of the nasal mucosa (percentage of eosinophils in smears was 33.5±13.3%) is requiring individualized anti-inflammatory treatment of such patients.

Conclusions. In patients with a comorbidity of bronchial asthma and allergic rhinitis in the dynamics of observation, the proportion of severe asthma which is poorly controlled by standard baseline therapy with a significantly higher risk of severe exacerbations of the disease increases.

Key words: bronchial asthma, allergic rhinitis, children, nasocytogram.

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Article received: Dec 13, 2018. Accepted for publication: Apr 04, 2019.