Haiduchyk H. Pathogenetic mechanisms of formation, peculiarities of course and optimization of diagnosis and treatment of allergic diseases of the gastrointestinal tract in children of early age

The thesis is devoted to improvement of diagnostics and treatment of allergic diseases of the gastrointestinal tract of children of early age based on the study of clinical and morpho-functional features of their course depending on the pathogenetic mechanisms of formation of allergic inflammation. Established early debut of allergic diseases of the gastrointestinal tract in children-during the first three months of life, which is often accompanied by lesions skin (58.7%) with a predominance in the clinical picture of diarrhea (63.9%) with a dash of large amounts of vitreous mucus and/or blood (29.5%), vomiting (40.3%), intestinal colic (53.2%) and complicated by iron deficiency anemia (43.2%) and hypotrophy (33.4%). Refined endoscopic, morphological and immunohistochemical characteristics of allergic inflammation of the digestive tract in children with food allergy. Based on the results of the elimination of provocative samples, basic food allergens have been established that induce the development of allergic inflammation of the digestive tract in children of the first three years of life: cow's milk (84.1%), eggs (42.5%), wheat (14.6%), soy (2.9%). According to the results of the analysis of the fat-acid spectrum, the metabolic indices that reflect the proinflammatory direction of the lipid spectrum of blood with a predominance of products of pro-inflammatory cytokines: activation of lipogenesis processes in IgE-dependent type of reactions to food proteins, and increasing the bioavailability of arachidonic acid and its pro-inflammatory metabolites (eicosanoids) in cell-mediated. The role of lipid mediators (cysteinyl leukotrienes of the 4th series) in the pathogenesis of protein-induced allergic inflammation of the gastrointestinal tract in children of early age has been proven. The algorithm of early diagnosis of allergic diseases of the gastrointestinal tract in children of early age, depending on the nature of feeding is developed. Scientifically grounded the differentiated approach to treatment and preventive measures in children of early age with allergic lesions of digestive tract with development of individualised schemes of treatment with application as the accompanying therapy of omega-3 polyunsaturated fatty acids, Lactobacillus rhamnosus GG or their enzymatic lizates in combination with рharmacotherapy (montelucast) and proved by their high efficiency.