Due to the prevalence of allergic rhinitis (AR) among the population of Russia, especially in pediatric practice, it is important today to give coverage to its clinical manifestations, principles of diagnosis, management of the patients and the possibilities to prevent exacerbations and increasing severity of illness. The authors provide the reasons behind why the intermittent AR has a persistent course. The article presents the diagnostic methods recommended in the ARIA documents. The authors note the important role of tight junctions in the nasal mucosa structure in protecting a person from aeroallergens and substantiate the rationality of prescribing systemic antihistamines to treat viral and a number of other types of infection. They also provide characteristics of minimal persistent inflammation and the distinctive features of local AR. According to the authors, the rationale for the use of complex treatment is the impossibility to completely cure AR. The article lists the activities and drugs included in the therapy regimen that is defined in the ARIA documents. However, the choice of a drug prescribed to the patient should be personified. The authors substantiate the prescription of systemic antihistamines in the development of acute respiratory viral infections caused by rhinovirus and give preference to Fenistil® due to the possibility of its use at an early age from 1 month in the form of syrup and drops as the most convenient dosage forms. The benefits of Fenistil® include: the speed of onset of a drug effect and its duration, high antihistamine activity and, as a result, pronounced itch relief, as well as the absence of a cardiotoxic effect, mild sedative effect, the ability of precise dosing and reduced production of nasal secretions. A clinical case with the rationale for the systemic use of this drug is presented. It is concluded that clinical data on the high efficacy and safety of Fenistil® entitle us to believe that its use is expedient, especially in pediatric practice.

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Rationale. Currently, the literature describes about 374 cases of Marshall syndrome. According to some authors, the prevalence of Marshall syndrome is 2.3 per 10,000 children, in general, the epidemiology of PFAPA syndrome in the pediatric population is unknown.Purpose. The aim of our study is to justify surgical treatment in children with Marshall syndrome. Objectives. The objectives of this study are to give a comparative assessment of the effectiveness of tonsillectomy and adenotonzyllectomy for this syndrome and to evaluate the quality of life indicators before and after surgical treatment.Materials and methods. The study included 26 patients with Marshall syndrome, of which 18 patients underwent adenotonzyllectomy and 8 patients underwent bilateral tonsillectomy. A clinical case of a typical manifestation of Marshall syndrome is also described, and follow-up results of the effectiveness of surgical treatment for Marshall syndrome are presented. In the course of the work, an adapted questionnaire was developed to assess the quality of life of parents of children with Marshall syndrome.Results. The result of our work is the fact that in relation to the relief of PFAPA-syndrome, children of preschool and primary school age have more effective adenotonsillectomy (88.2%), while tonsillectomy was effective only in 55.6% of patients.Conclusion. A multidisciplinary approach is required to address the diagnosis and treatment of Marshall syndrome.