Difficult patient with bronchial asthma: a clinical case
- Authors: Bashkina O.A1, Vyazovaya I.V1, Sergienko D.F.1
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Affiliations:
- Astrakhan State Medical University
- Issue: Vol 29, No 10 (2022)
- Pages: 94-97
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/321094
- DOI: https://doi.org/10.18565/pharmateca.2022.10.94-97
- ID: 321094
Cite item
Abstract
Background. In recent years, there has been an understanding that atopic dermatitis (AD) and atopic bronchial asthma (BA) in childhood are diseases associated with T2 inflammation, which determines the development and introduction of pharmacological agents for biological therapy with monoclonal antibodies into clinical practice. However, this therapy is not always successful, which prompts the search for other methods of treatment to control allergic diseases. Description of the clinical case. This article presents a clinical case of the course and treatment options for BA combined with other intercurrent diseases and comorbid conditions. A clinical example of dermatorespiratory syndrome of atopic genesis in a 13-year-old patient is discussed, variants of basic therapy in the context of clinical response are presented, and algorithms for the clinical search for possible causes and conditions that impede the achievement of control over the course of a severe BA in combination with AD are demonstrated. The development of a side effect with the use of dupilumab, which led to the withdrawal of the drug, is described. Conclusion. Despite the developed therapy algorithms, the treatment of combined allergic pathology remains a challenge that requires an individual approach. The issue of prescribing immunobiological therapy for patients with a severe therapy-resistant course of the disease should be raised in a timely manner; however, it is necessary to take into account comorbid conditions and the possibility of adverse side effects that serve as an obstacle to targeted therapy. Thus, the therapy of BA and AD will remain complex and strictly personalized task.
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About the authors
O. A Bashkina
Astrakhan State Medical UniversityDepartment of Faculty Pediatrics Astrakhan, Russia
I. V Vyazovaya
Astrakhan State Medical UniversityDepartment of Faculty Pediatrics Astrakhan, Russia
Diana F. Sergienko
Astrakhan State Medical University
Email: gazken@rambler.ru
Department of Faculty Pediatrics; Dr. Sci. (Med.), Professor Astrakhan, Russia
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