The normal serum tryptase level is 0–11.4 ng/ml. Hypertryptasemia occurs with anaphylaxis, systemic mastocytosis, and cutaneous mastocytosis in children. Recently, mast cell activation syndromes are increasingly being diagnosed. The article discusses the main reasons for the increase in the concentration of tryptase in children. Allergists must correctly interpret its causes.

The study focused on spontaneous and allergen-induced basophil activation (BAT) as well as on specific IgE indicators to major meadow grass pollen allergens on the background of allergen-immunotherapy (AIT) in patients sensitized to weed pollen. The study revealed that the specific IgE indicators to major ragweed allergens (nAmb a 1) and wormwood (nArt v 1) allergens, as well as the ratios of spec. IgE nAmb a 1/gen. IgE, and spec. IgE nArt v 1/gen. IgE do not change after 2 courses of pre-seasonal ASIT. There was a decrease detected in BAT indicators under the effect of ASIT. An early decrease in the BAT stimulation index (BAT IC) was shown to be more common for patients with positive treatment outcomes.

The development of nephrotic syndrome (NS) among children is accompanied by the observable changes of the immune status, which are manifested by the disbalance of lymphocytes subpopulations, dysimmunoglobulinemia and the disturbance of the metabolic activity of phagocytes. Immunological, associated with higher level of total IgE and HVI phenotypes of nephrotic syndrome among children were identified. NS of hyper IgE-phenotype is characterized by the increase of general IgE level in the peripheral blood. NS associated with HVI is characterized by the activation of humoral antiherpetic immunity, which was manifested by the presence of active HVI markers in the blood (Ab IgM and/or Ab IgG of low avidity to VH) on the background of clinical manifestations of HVI: the presence of fever, lymphadenopathy, enlargement of liver and spleen, skin and mucous rashes. The addition of antivirus drugs to the standard basic treatment of NS stopped the clinical signs of HVI exacerbation and optimized NS therapy.

Introduction. Hypertrophic and polyposis changes in the synonasal mucosa (SNM) in patients with bronchial asthma (BA) and allergic rhinitis (AR) negatively affect the course of these diseases. The debut of their formation can be observed already in childhood, but there is currently no precise information about the course of this pathology in children with BA and AR. The features of systemic immune regulation in these patients are also not studied.

Purpose of the study. To study the effect of hypertrophic and polyposis changes in SNM on the clinical characteristics of AR in children with BA and on their relationship with the content of serum immunoglobulins A, M, G and E. Materials and methods. We examined 137 patients with atopic BA and AR at the age of 10.0 [7.0; 13.0] years, of which boys — 75.2% (103/137). Patients underwent routine examination of ENT organs and video endorhinolaryngoscopy, if indicated — CT scan of the paranasal sinuses. Determination of the content of total IgE, as well as IgA, IgM, IgG in blood serum was carried out by the enzyme-linked immunosorbent assay "VectorBest" (Russia).

Results. In 19.7% (27/137) children, changes in SNM were revealed in the form of local hypertrophy of the medial surface of the turbinates, in 10.9% (15/137) polyposis changes in SNM. These changes in SNM were statistically significantly more frequent in patients with moderate and severe AR (χ2=57.7; p<0.001). The content of serum total IgE was comparable in children with the absence and presence of synonasal hypertrophy (p=0.65), as well as in serum IgM (p=0.74). At the same time, the serum IgA content in children with synonasal hypertrophy unexpectedly turned out to be statistically significantly higher (p=0.024), and the serum IgG content had a clear tendency to increase (p=0.053) compared with children who did not have hypertrophic changes in SNM.

Conclusion. The course of AR in children with BA may be accompanied by the formation of hypertrophic and polyposis changes in the SNM, which are associated with a more severe course of AR and with an increased expression of synonasal symptoms. Children with hypertrophic changes in SNM were found to have a statistically significantly higher level of total serum IgA compared with children without SNM hypertrophy. Apparently, patients with BA and AR with hypertrophic changes in SNM have a unique systemic immunological profile that requires serious study.

We studied the possibility of prescribing antileukotriene drugs in children with recurrent laryngotracheitis for the prevention of bronchial obstruction. Examined 120 children (71 boys and 49 girls) with recurrent laryngotracheitis at the age of 3–9 years at the beginning of observation. Allergic diseases (allergic rhinitis, atopic dermatitis) were diagnosed in 80 children, divided into groups Ia and II of 40 people, respectively, before inclusion in the study. The level of total serum IgE in children ranged from 50 to 2000 IU/ml, polysensitization was noted (to household, pollen, fungal allergens). Patients of the I-st group received therapy according to the standards of treatment for obstructive laryngotracheitis. Group II, consisting of 40 patients with allergic deseases, additionally received 2 months montelukast courses trice a year, in periods without episodes of recurrent laryngotracheitis. For 3 years of follow-up, it was possible to determine groups of children with recurrent laryngotracheitis in combination with repeated bronchitis with obstructive component (50%), some of patients were diagnosed with mild intermittent bronchial asthma (21,9%). The formation of bronchial asthma was observed in children with allergic diseases who did not receive montelukast in 32% of patients, and in 15% of children who received montelukast, the difference is reliable. Prescription of montelukast for children with recurrent laryngotracheitis in combination with allergic diseases, family history of atopy, and the monitoring of an allergist are recommended.