Pathogenesis of infectious-allergic bronchial asthma

The pathogenesis is complex, includes various immuno-non-immunological mechanisms. Infectious-allergic bronchial asthma is characteristic of middle age: the maximum incidence in 30-40 years. An allergic predisposition is less common than with bronchial atopic asthma, but the downstream inheritance rate is quite high. The most constant clinical sign of the disease (noted in the vast majority of cases) is a connection with previous infectious and inflammatory diseases of the respiratory tract, among which bronchitis occurs twice as often as in atopic asthma. Attacks of suffocation appear during the decline of acute infections (possible in the acute period), some time after them (two to four weeks), or against the background of a recurring chronic inflammatory process. The deciding factor may be stress or various non-specific irritants. The predominant form of upper respiratory tract damage is allergic rhinosinusopathy, purulent lesion of the sinuses is often observed (810 times more often than with atopic bronchial asthma), which precedes the onset of the process in the bronchi: recurrent bronchitis, to which asthma attacks join. In a number of patients, it begins after another exacerbation of purulent sinusitis. Typical clinical signs of malignancy are hyperplastic sinusitis, polyposis of the nose and sinuses. In many cases of infectious-allergic bronchial asthma, food allergies and drug allergies are associated.
The clinical signs of expiratory suffocation in infectious-allergic bronchial asthma are divided into two types: similar to typical asthma attacks, but with a less clear beginning and end; prolonged, lasting from several hours to several days and accompanied by an almost constant cough with the release of mucous mucous sputum (against this background of difficulty breathing, asthma attacks may occur). Most patients combine both types of suffocation. In the lungs, dry rales of a different nature are heard (low tone, whistling), there may be scattered sonorous moist rales. At the height of the attack, dry rales of a high tone prevail. In the absence of attacks, more or less dry wheezing remains. Infectious-allergic bronchial asthma is characterized by a more severe course with a pronounced tendency to asthmatic statuses. A tendency to seasonal exacerbations in the cold season is characteristic – late autumn, winter, early spring. At a certain stage, seasonality is lost, attacks bother patients at any time of the year. Complete remissions are rare, only in the early stages of the disease, are short-lived. The course is progressive. Complications develop early – in the first 3-4 years. The most common of them is emphysema. In almost all patients, repeated exacerbations of the disease are associated with respiratory infections (the dominant symptom). High-temperature viral flu can cause temporary remission. In infectious-allergic bronchial asthma, the effect of secondary provoking factors is more pronounced: cooling, neuropsychic and physical. stresses, negative emotions, weather changes. In patients with infectious-allergic bronchial asthma , premenstrual asthmatic syndrome is more common and more pronounced. At a certain stage of the disease, non-infectious allergies may develop in patients.

local_offerevent_note December 1, 2019

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