Kijanje – simptom respiratorne ili psihogene superpozicije bolesti u tinejdžera?

  • Anđelka K Stojković Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
  • Slobodan Obradović Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
  • Dejan Jeremić Faculty of Medical Sciences, University of Kragujevac, Serbia
  • Aleksandra Simović Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
  • Maja Vulović Faculty of Medical Sciences, University of Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP150902265S
Ključne reči: adolescent||, ||adolescenti, rhinitis, allergic||, ||rinitis, alergijski, tic disorders||, ||tik poremećaji,

Sažetak


Uvod. Udruženost alergijskih respiratornih oboljenja i psihogene ili psihijatrijske bolesti je moguać, premda se javlja retko kod devojčica u tinejdžerskom uzrastu. Prikaz bolesnika. Devojčica uzrasta 12,5 godina primljena je u Pedijatrijsku kliniku Kliničkog centra Kragujevac sa glavnom tegobom kijanje, po 10 uzastopnih kijanja u serijama od 500–600 dnevno i to samo u budnom stanju. Radne dijagnoze bile su tik poremećaj udružen sa alergijskim rinitisom, astmom i biohemijski utvrđenim rahitisom. Tinejdžerka je lečena hlorpromazinom, desloratadinom, montelukastom, flutikazon propionatom, vitaminom D, azelastin-hidrohloridom, sa pratećom eliminacionom ishranom. Posle perioda od godinu i po dana, bolesnica je ređe kijala, periodi bez kijanja nisu bili duži od 3 meseca i povremeno je „čistila grlo“. Mada je sada klinička slika bila blaža i bez dodatnog motornog tika ili simptoma Tourette poremećaja, zbog dužine trajanja tegoba postoji sumnja da se tik preobratio u hronični glasovni tik poremećaj. Zaključak. U radu je prikazana retka udruženost alergijskog rinitisa i stanja tik-srodne konverzije kod tinejdžerke i istaknuta je potreba za reviziju sistematizacije tik poremećaja i protokola za alergijski rinitis u smislu njihove udruženosti.

Biografije autora

Anđelka K Stojković, Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
Odeljenje pulmologije, alergologije, kardiologije, nacelnik
Slobodan Obradović, Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
Odeljenje neuropedijatrije - nacelnik
Aleksandra Simović, Paediatric Clinic, Clinical Centre "Kragujevac" Faculty of Medical Sciences, University of Kragujevac, Serbia
Centar za neonatologiju

Reference

Reynolds YH, Elias AJ. Pulmonary Defense Mechanisms against Infections. In: Fishman PA, Elias AJ, Fishman AJ, Grippi AM, Senior MR, Pack IA, editors. Fishman`s Pulmonary Disease and Disorders. New York: McGraw Hill Companies; 2008. p. 279−90.

Pfaar O, Raap U, Holz M, Hörmann K, Klimek L. Pathophysiolo-gy of itching and sneezing in allergic rhinitis. Swiss Med Wkly 2009; 139(3−4): 35−40.

Katial RK, Meltzer EO, Lieberman P, Ratner PH, Berger WE, Kaliner MA, et al. Suggested updated approaches to patient management. Ann Allergy Asthma Immunol 2011; 106(2 Suppl): S17−9.

Songu M, Cingi C. Sneeze reflex: facts and fiction. Ther Adv Respir Dis 2009; 3(3): 131−41.

Walkup JT, Ferrão Y, Leckman JF, Stein DJ, Singer H. Tic disor-ders: some key issues for DSM-V. Depress Anxiety 2010; 27(6): 600−10.

Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010revision. J Allergy Clin Immunol 2010; 126(3): 466−76.

Global Initiative for Asthma, GINA. Global Strategy for Asthma management and prevention [report updated 2015]. Available from: erj.ersjournals.com/content/.../2015/07/.../13993003.00853-2.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-5. 5th ed. Washington, DC: American Psychiatric Association; 2013.

Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. Tourette syndrome and tic disorders: A decade of progress. J Am Acad Child Adolesc Psychiatry 2007; 46(8): 947−68.

American Society of Health-System Pharmacists. Chlorpromazine Hydrochloride [2015 December 1]. Available from: http://www.drugs.com/monograph/chlorpromazine-hydrochloride.html

Bhutta MF, Maxwell H. Sneezing induced by sexual ideation or orgasm: An under-reported phenomenon. J R Soc Med 2008; 101(12): 587.

Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS, et al. Serum vitamin D levels and severe asthma ex-acerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol 2010; 126(1): 52−8.e5.

Objavljeno
2017/10/27
Broj časopisa
Vol. 74 Br. 10 (2017)
Rubrika
Prikaz bolesnika