Gnatenko T. Clinical and pathogenetic rationale of antirecurrent treatment of the acetonemic vomiting syndrome in children with somatic diseases.

Presented data retrospective study of modern features of the acetonemic vomiting syndrome (AVS) in children, approved an increase of frequency of detection of AVS in 5 times during ten years (2002-2012), and the phenomenon of the so-called "rejuvenation" of patients with AVS. Included and analysed the results of prospective comprehensive survey of 94 children aged from 3 to 10 years with recurrent AVS and the somatic pathology (study group) and 30 healthy children in comparison group. Determined significant prognostic factors and mathematical model predicting recurrent course AVS in children. Improved diagnosis of metabolic disorders in recurrent AVS based on the definition of organic acids urine by gas chromatography/mass spectrometry. During of the AVS crisis revealed a number of significant energy metabolic disorders in the Krebs cycle, the process of glycolysis, oxidation of fatty acids and aminoacids metabolism. Established that recurrent AVS often (61.7 %) is found in children with phenotypic features of undifferentiated connective tissue dysplasia and characterized by an increase in 2 times the level of degradation of collagen-hydroxyproline peptide. Proved that the metabolic disorders in children with AVS characterized by magnesium and vitamin B6 deficiency. Found that most patients with AVS characterized as children with personal and situational anxiety, which eliminated under metabolic therapy. Based on the research results scientifically proved developed, tested a comprehensive phased therapy AVS using correction with high-energy therapeutic children's nutrition and the elimination of deficiency of magnesium and vitamin B6 preparation and mineral water containing these components on the background normalization of life and hypoketogenіc diet, according the type of crystalluria. Comparative and follow-up observations have confirmed a significant reduction in the duration and severity of clinical manifestations of the AVS crisis, normalization of metabolic disorders, improved the psychosomatic condition of children and decreased the frequency and severity recurrences of AVS.