Diathesis in children

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Diathesis or constitutional anomaly is a congenital feature of the child's body, which is prone to this or that disease. The term diathesis - means prone to any disease. This concept is not a disease or a syndrome, it is a characteristic of the child that he or she becomes susceptible to the disease. About 90% of chronic diseases in children occur against the background of diathesis.

Types of diathesis

There are about 20 types of diathesis in medicine. At the same time, there are individual manifestations that occur in some groups of children. The following types of children's constitutional anomalies are distinguished:

• Exudative-catarrhal;

• Nervous-arthritic;

• Lymphatic-hypoplastic.

Exudative-catarrhal (allergic) diathesis - manifests itself in the form of various allergic diseases in children at an early age. Over time, such diseases take the form of infectious-inflammatory or chronic allergic diseases.

Lymphatic-hypoplastic diathesis is a primary immunodeficiency condition characterized by hyperplasia of the thymus (lymph nodes) and lymph nodes.

Neuro-arthritic diathesis - occurs in the form of diseases associated with disorders of purine and uric acid metabolism.

Causes of diathesis

Diathesis is based on neuroendocrine disorders of immunological and metabolic processes, and pathological conditions in which the body reacts strongly to even the simplest influences.

Risk factors leading to diathesis include a woman’s diet during pregnancy, cases of toxicosis, infectious diseases, bad habits, asphyxia, and fetal hypoxia. In addition, children prone to diathesis are children with perinatal MNT (central nervous system) damage, overweight or underweight at birth, as well as children on artificial feeding and children with intestinal dysbacteriosis. Factors that exacerbate the course of diathesis include poor care, inattention to diet, vaccinations, chronic infections, stressful situations, and more.

Exudative-catarrhal diathesis can be caused by defects in the gastrointestinal tract, low enzyme activity, lack of biogenic amines, instability of cell membranes. This type of diathesis also plays a big role in the mother's diet, such as eating a lot of citrus fruits (lemons, oranges, mandarins), berries (strawberries, raspberries), fish, sausages, tomatoes and chocolates.

The causes of lymphatic-hypoplastic diathesis are not clear. This type of diathesis is more common in premature and frail children. Chronic endocrine diseases in the mother play a major role in its origin.

If a woman's amniotic fluid arrives prematurely during childbirth, birth process the risk of developing lymphatic-hypoplastic diathesis is increased even if fetal hypoxia or injury is observed.

Neuro-arthritic diathesis is caused by hereditary factors (disorders of uric acid and purine metabolism) and excessive consumption of meat products by a pregnant woman or child. Often children with such diathesis are observed in close relatives with urinary or gallstone diseases, gout, neurasthenia, arterial hypertension, diabetes, atherosclerosis and other pathologies. All of these are diseases caused by metabolic disorders.

Clinical manifestations of diathesis in children

Exudative-catarrhal diathesis - is manifested by damage to the skin and mucous membranes as a result of allergic reactions and prolonged inflammatory processes. This type of diathesis most often occurs in young children and passes around the age of 3-4 years. Occurs in 40-70% of cases of general diathesis.

Exudative-catarrhal diathesis in the form of seborrheic dermatitis in one-month-old children - oily itching occurs in the hairy part of the head, in the upper area. Usually, the outcome of such pathology is positive, but in some children it progresses to seborrheic eczema, which occurs in the form of swelling, redness, watery blisters in the neck, ears and forehead.

In children, exudates are retained in the buttocks and skin folds. In some children, pyoderma is also caused by an infectious mixture of watery or matte skin. The most severe manifestation of exudative-catarrhal diathesis is pediatric eczema. With age, this process can take the form of neurodermatitis.

Exudative-catarrhal diathesis occurs in paratrophic (obese) children. Because their skin is thin, their face is swollen, their tongue is "geographical", they have abdominal syndrome and flatulence. Children with diathesis are prone to respiratory diseases (pneumonia, bronchitis, tonsillitis, pharyngitis). Exudative-catarrhal diathesis should be distinguished from psoriasis, erythroderma, dermatitis, and others.

Lymphatic-hypoplastic diathesis - manifests itself in the form of enlargement of the lymph nodes and pathologies of the endocrine glands. Such children are prone to infectious diseases and allergies. This form of diathesis occurs in children aged 3-7 years and accounts for 10-12% of total diathesis.

In the positive course of diathesis passes until puberty. Lymphatic-hypoplastic diathesis is characterized by dysfunction of the sympathoadrenal system and adrenal glands, compensatory hyperplasia of lymph tissue, decreased function of the pituitary gland and a decrease in cellular and humoral immunity.

Children with such diathesis have a disproportionate body structure (short body, long arms and legs), pale skin, decreased skin firmness, poorly developed muscles. Such children become adynamic, weak, and quickly tired. They are prone to arterial hypotension, are more prone to O 'RVI-influenza, neurotoxicosis occurs, microcirculatory disorders and hyperthermia are observed.

Lymphatic-hypoplastic diathesis is characterized by enlargement of peripheral lymph nodes, thymomegaly, hyperplasia of the adenoids and tonsils, enlargement of the liver and spleen. After removal of the adenoids, it may grow back again. In addition, this diathesis also causes developmental abnormalities, hyperplasia of the kidneys, heart, external genitalia.

It is in these diatheses that sudden death of children is observed. When lymphoco-hypoplastic diathesis is suspected, HIV infection and lymphogranulomatosis should be ruled out.

In neuro-arthritic diathesis, the function of enzymes is impaired, resulting in defects in the metabolism of carbohydrates and lipids as a result of the metabolism of uric acid and purine.

This type of diathesis is less common than other diatheses - in 2-5% of cases. Underlying this disease are metabolic, neurasthenic, skin and spastic syndromes due to impaired "cleansing" function of the liver.

Neuro-arthritic diatheses also occur in older children and are manifested by urinary and gallstone diseases, obesity, nephritis, chronic renal failure, gout, atherosclerosis, diabetes mellitus.

Neurasthenic syndromes are observed in 80% of children with such diathesis. In the early years of childhood, this diathesis is manifested by a child's extreme agitation, cowardice, restlessness, sleep disturbances. In preschool and early school periods, children become more assimilated, have more vocabulary, have a stronger memory, are curious about the external environment, and are fun. But they show more headaches, emotional lability, enuresis, anorexia.

Arthralgia due to dysuria is caused by metabolic disorders in neuro-arthritic diathesis. Phosphate salts, oxalates and urates increase in urine. Acetone syndrome is observed due to decreased liver acetyl acid clearance. Symptoms of intoxication with acetone, repeated vomiting, hyperthermia, dehydration.

Spastic syndromes include migraine headaches, bronchoconstriction, arterial hypertension, cardialgia, spastic colitis, constipation, kidney and intestinal attacks. Most often, bronchial asthma occurs in children with this type of diathesis.

In neuro-arthritic diathesis, it occurs by the skin in the form of eczema, pruritus, quince tumor, eczema, or neurodermatitis.

Differential diagnosis of neurosis, rheumatism, with diabetes and a positive Mantoux test (tuberculosis).

Diagnosis of diathesis

Diathesis is not an independent disease and diagnosis, so children with diathesis should be examined by a pediatrician, pediatric neurologist, endocrinologist, dermatologist, nephrologist, rheumatologist, allergist-immunologist and other specialists.

In diathesis, laboratory tests include general analysis of blood and urine, biochemical examination of blood, the amount of phospholipids, cholesterol, glucose, catecholamines, uric acid. In addition, B and T lymphocytes, IgA and G are immunologically examined and feces are examined for dysbiosis.

Ultrasound examination of lymphatic-hypoplastic diathesis is also performed. X-rays of the spleen, liver, adrenal glands and pancreas, as well as chest organs are also studied.

Diathesis treatment

Treatment of nomedicomentosis of diathesis includes child care, adjustment of diet and ration, physiotherapeutic treatments. Babies with exudative-catarrhal diathesis should be breastfed, and older children should follow a diet, limiting exposure to products.

Medicomentosis drugs are prescribed sedatives (valerian extract, persen) and antihistamines (diazoline, claritin), a type of vitamin B belonging to the group. If dysbiosis occurs on the background of diathesis, probiotics (linex, lactovit, bifidumbacteria) are used.

For topical application in exudative-catarrhal diathesis is recommended to take baths with chamomile (chamomile), oak root. Non-hormonal anti-inflammatory ointments are applied to the affected skin area. Treatment with general ultraviolet light also gives good results. Hyposensitization procedures are performed under the supervision of an allergist.

Lymphatic-hypoplastic diathesis is treated with synthetic and natural adaptogens (pentoxyl, eleutherococcus), vitamins, general massage and gymnastics. In adrenal insufficiency, glucocorticoids are prescribed.

In neuro-arthritic diathesis, it is necessary to strictly limit purine-rich products from the diet of children. Such products include cocoa, chocolate, peas, liver and fatty products. As a complex treatment, herbal medicines and sedatives, B vitamins and gymnastic exercises are prescribed. In acetonemic vomiting, measures such as rehydration (drinking fluids or intravenous infusions), enemas, gastric lavage are performed.

Prevention and prognosis

Women pregnancy in time to protect against genital diseases and toxicosis, should choose a hypoallergenic diet. Breastfed babies should be fed only milk, and older children should be limited to allergic products. Vaccination of children with diathesis is also carried out on a separate schedule.

If the diathesis is correctly diagnosed and treated correctly, the outcome will be positive. In most cases, diathesis resolves spontaneously during puberty.

Please note that the chemicals mentioned in the article are listed for reference only. Treatment of diathesis should be carried out under the supervision of a physician, according to his recommendations!