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Allergisch astma en allergische rhinitis

Allergisch astma en allergische rhinitis. Ghislaine de Geus-Francken Gelderse Vallei te Ede 25 sept 2013. Allergie bij kinderen. 10-15 % van alle kinderen Jonge kinderen : voedselallergie en constitutioneel eczeem 1-3 jaar : Start astma-achtige ziektebeelden

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Allergisch astma en allergische rhinitis

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  1. Allergisch astma en allergische rhinitis Ghislaine de Geus-Francken GelderseValleite Ede 25 sept 2013

  2. Allergie bij kinderen • 10-15 % van allekinderen • Jonge kinderen: voedselallergie en constitutioneeleczeem • 1-3 jaar: Start astma-achtigeziektebeelden • Schoolleeftijd: hooikoortsklachten en urticaria • Alleleeftijden: anafylaxie

  3. Voedingsallergie • immunologischereactie op eiwitfractie in voeding - prevalentie 20-30 per 1000 zuigelingen/jaar - vnlkoemelkallergie en kippe-eiwit - veel, voornamelijkaspecifiekesymptomen van maagdarmkanaal en huid, incl failure to thrive

  4. Allergisch astma en leeftijden

  5. Hay fever Allergic Asthma Atopic Dermatitis Exponential rise in childhood allergy Ninan and Russel 1992 BMJ 304:873 15 12 9 % 6 3 0 1964 (n=2510) 1989 (n=3403) “Aberdeen study” 8-13 yr old children

  6. The allergyepidemicextendsbeyond the past few decades Isolauri et al Clin Exp Allergy 2004;34:1007-10

  7. Hygiëne hypothese Grote gezinnen: lager risico op allergischeaandoeningen D Strachan 1989

  8. Siblings, day-care and the risk of asthma Ball TM et al NEJM 2000;343:538-43

  9. Th3 Th0 Th2 Th1 antigenen Th2 infectie darm flora endotoxine allergenen Th1 sensibilisatie allergische aandoeningen tolerantie autoimmuun ziekten

  10. Th2 cel IL-5 IL-4 eosinofiel B cell IgE MBP, ECP mest cel histamine heparine leukotrieenen cytokines epitheel gladde spier

  11. Naiveindividuals Germ-free, hygienic environment Westernizedlifestyle? Use of antibiotics? Vaccination? Allergysensitization Influenza Asthma, allergies, eczema Th2 response genetic predisposition Poor hygienic environment Early childhood infections (HepA, TB?) Microbial exposure Older siblings Daycare Farming environment Early exposure to dogs, cats Protective response healthy, no asthma

  12. Klachten bij astma en/of rhinitis bij kinderen: Anamnese; -

  13. Behandeling allergisch astma

  14. Behandeling allergische rhinitis

  15. Preventie mogelijkheden:

  16. Incidence of asthma in 812 grade 1-6 schoolchildren Riedler et al. Lancet 2001 20 10 % asthma in past 12 months 0 no stables no farm milk farm milk, but no stables in 1st year stables / farm milk in 1st year stables / farm milk after 1st year stables but no farm milk in 1st year

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