Pediatrics

Pediatric Allergy

The Department of Pediatric Immunology and Allergy is a specialty that deals with the diagnosis, treatment and follow-up of the immunological, ie immune system, and allergic diseases of children between the ages of 0-18. In addition to many different diseases, the physicians of this department also work with the bone marrow and stem cell transplant center to perform immunological tests and HLA typing before transplantation.

Parallel to this, HLA typing required for solid organ transplantation, lymphocyte cross-match analysis and immunological tests using the most up-to-date methods are also applied by the physicians of this department at the international level. Prevention of infectious epidemic diseases that can deeply affect society is also among the job descriptions of physicians of the pediatric immunology and allergy departments. Pediatric immunology and allergy diseases physicians specialize in medical school for 6 years, pediatric residency for 4 years and in the department of pediatric immunology and allergy diseases for 3 years.

What is the Department of Pediatric Immunology and Allergy?

Prevention of infectious epidemic diseases that can deeply affect society is also among the job descriptions of physicians of the pediatric immunology and allergy departments. Pediatric immunology and allergy diseases physicians specialize in medical school for 6 years, pediatric residency for 4 years and in the department of pediatric immunology and allergy diseases for 3 years.

The Department of Pediatric Immunology and Allergy is the department where the diagnosis and treatment of many immunological-based diseases such as immunodeficiency and infection types are made at international level. It is also a branch of science that deals with the diagnosis and treatment of allergic diseases that occur with the interaction of genetic and environmental factors.

There are many immunological and allergy-induced diseases. These include allergic rhinitis, known as hay fever or spring fever, allergic and non-allergic bronchial asthma, food, drug, insect and skin allergies defined as atopic dermatitis, recurrent wheezing episodes and anaphylactic shock, and severe allergic reactions which require immediate attention.

Weakness in the immune system due to different reasons often manifests itself as having infectious diseases, while allergic diseases mostly manifest themselves with the following symptoms:

Itching on the skin
Redness, blistering and swelling of the skin
Eczema
Recurrent dry cough and sneezing
Shortness of breath
Wheezing
Runny nose, itching and congestion
Tearing, redness and itching of the eyes
Abdominal pain
Diarrhea
Vomiting
Presence of blood or mucus in stool

Tests Performed in Pediatric Immunology and Allergy Department

A physical examination is performed after the detailed history taken by the physician depending on the patient’s complaints. When deemed necessary, laboratory tests and radiological imaging methods are used. The tests frequently applied by department physicians are as follows:

Prick Test:

In this test, also known as the scratch test, a drop of allergen liquid is dropped on the back or the inner surface of the arm, the lower part of the elbow. With the help of a sterile, pointed metal rod, in other words, with the lancet, a superficial scratch is created on the skin. Thanks to this frequently applied test, which is painless and results in a very short time, allergens originating from house dust allergens, plant pollens, pets such as cats, dogs and birds are evaluated.

Intradermal Test:

In other words, the intradermal test is used to detect allergies that develop due to bee stings or drugs. A very small amount of allergen fluid, such as 0.01 – 0.02 ml, is administered subcutaneously to the arm or back area with the help of a very fine-tipped insulin injector. The possibility of systemic reactions is increased by applying 4 or 5 antigens at the same time. The patient is kept waiting for 20 minutes with the injection site open. In the meantime, the patient is warned not to scratch these areas.

Patch Test:

Patch test is used in the diagnosis of contact dermatitis, reactions against substances that contact the outer surface of the body, allergic formations such as dermatitis and urticaria. Necessary allergens are placed in the relevant area of ​​the adhesive tape, which is defined as the patch test unit and has small chambers at the bottom, and adhered to the back area. The tape is removed approximately 2-3 days after the allergens in the chambers inside the unit come into contact with the body. During this period, the patient should not take a shower or engage in physical activity to increase sweating. In order to detect some late reactions, the patient should go to the physician control again 2-3 days after the tape is removed.

Specific IgE Test:

It is a blood test against a certain allergen that is suspected according to the patient’s history. Specific IgE is not a general allergy screening, but a type of test for certain groups of allergies. For example, Type 1 hypersensitivity reactions include hay fever, asthma, atopic dermatitis, rash, and systemic anaphylaxis. In addition, test groups such as foods and food mixtures, epithelial and animal protein, epithelial and animal protein mixtures, grass, grain and pollen, some occupational allergens, mold fungi and yeast mixtures, various tree pollen mixtures, weed and flower mixtures can be applied. This test is studied in the blood taken from the patient in a laboratory environment.

Spirometry:

Spirometry, known as SFT, or respiratory function test, is performed to evaluate diseases that affect heart and lung functions such as asthma, and to measure the capacity and functional status of the lungs. Basically, it is the measurement of how much the patient breathes into his lungs and how much of that breath is delivered back in a given time interval. Before performing the respiratory function test, the patient should not be out of breath and return to normal breathing. During the test, the nose is closed and a disposable mask is placed in the mouth. The patient is asked to take a strong and very deep breath, and the patient is asked to breathe at the doctor’s signal. In this way, the test is repeated 3 times and the necessary evaluation is made on the basis of the best result. It is not recommended for patients to be hungry or very full before coming for the test. In addition, it is not recommended to wear tight clothing that will prevent chest and abdominal movements as it may cause errors in tests. It is also important that he has not consumed cigarette and alcohol during the 24 hours before the test so that the result of the test is not affected.

Rhinomanometry:

Known as nasal breathing measurement, rhinomanometry is a test to measure nasal airway resistance. In this way, the degree of possible blockages and changes in the airway and pressure are determined.

What is Immunotherapy Treatment?

In addition to drug therapy, immunotherapy can be applied to patients with conditions such as allergic asthma, allergic rhinitis or bee allergy, which are thought to meet the necessary criteria for treatment. Immunotherapy, also known as allergy vaccine or vaccine therapy, is especially applied to allergic patients who want to be protected from allergens and who cannot be controlled despite drug use or who have side effects due to drugs. Depending on the age of the patient, tablet immunotherapy, sublingual drop vaccine or subcutaneous vaccine can be applied.

Tablet Immunotherapy:

It is a treatment that has been used orally in recent years. Allergens are administered daily using a tablet that dissolves under the tongue. The tablet is kept in the mouth for 1 minute and then swallowed. The drug should not be eaten or drunk within the first 5 minutes after ingestion.

Sublingual Drip Vaccine:

Sublingual Immunotherapy is a method that can be applied by the patient himself. The solution containing allergen solutions is dropped under the tongue and left in the mouth for 2 minutes and swallowed. It can be applied every day in the beginning under the supervision of the physician, then 3 days a week.

Subcutaneous Vaccine:

In the application referred to as subcutaneous immunotherapy in the literature, the allergen solution is given under the skin with a very fine-tipped injector. Injections applied to the upper outer part of the arm are applied to a different arm each time and the patient is observed for the first half hour. It is normal to have hard lump-shaped swelling at the injection site.

Do not neglect to have your checkups regularly for early diagnosis and treatment of allergies, immunodeficiency and many other diseases.