Common Allergic Diseases in Children Sang - Il Lee, M.D. Department of pediatrics Sungkyunkwan University School of Medicine, Samsung Medical Center E - mail : silee@smc.samsung.co.kr Abstract Allergy is an untoward physiologic response in host which is acquired by immunologic mechanisms. Allergic diseases are one of the most common chronic diseases in children and teenagers and have increased since the latter half of the 20th century around the world. The rapid increase of allergic diseases were also reported during the 1980s in Korea. Environmental changes play an important part in the development of allergic diseases, although genetic factor is fundamentally involved in the pathogenesis of allergy. Many studies have explained that allergy is the process in which it divides into production of chemical mediators by attachment of allergen to mast cell and hyper - responsiveness of the target organ by interaction with chemical mediators. However, although many diagnostic methods and treatment sources have been developed from these concepts, the mechanism of the allergy is not yet fully understood. Several researchers and societies have attempted to make guidelines for the diagnosis and treatment of allergic diseases. However, it is difficult to set guidelines, because children frequently suffer from variable non - allergic diseases which show symptoms similar to allergy. Therefore, it is helpful to approach allergic diseases in children by their age group. We suggest approaches for the diagnosis and management of bronchial asthma, allergic rhinitis and atopic dermatitis which are common in children according to their age group. Keywords : Asthma; Allergic rhinitis; Atopic dermatitis 231
(Sensitization) (Target organ hyperirritability) (Hypersensitization) (Hyperreactivity) (Allergic inflammation) Physiologic responses Pathologic responses Symptoms Peripheral vasodilatation Edema Itching, cough, sneezing, abdominal cramp Glandular hyperreactivity Hypersecretion Sputum, rhinorrhea, diarrhea Smooth muscle contraction Constriction Wheeze, vomiting 232
Asthma; inflammatory Disease Allergic Causing Agents mite, pollen, food, molds, animals, drugs... Non-allergic Causing Agents infections: virus, bacteria, Mycoplanma... Non-specific triggers weather, air - pollutions, exercise, aerosols, temperature, chemicals... Exposure Re - exposure Exposure Exposure Allergic Stare Acute Symptom Inflammation Hyper - Reactivity Chronic Symptoms Genes Resolution Acute Symptom Avoidance Symptomatic Anti - inflammatory Mast cell Immunotherapy Educations Supervision Medication Medication Stabilizer 233
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Total IgE Eosinophils Specific IgE (RAST, PRIST, CAP, MAST) (Allergy skin test) (Allergen challenge test) (Non - specific challenge test) 235
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