Among all allergic diseases in pediatric practice, allergic rhinitis is one of the most common pathologies of the upper respiratory tract. This review deals with the problem of modern principles for the diagnosis and treatment of allergic rhinitis in children based on the analysis of literature sources using electronic databases PubMed, Web of Science, MedLine, the Cochrane Library. Allergic rhinitis is an important medical and social problem of our time the importance of which has increased significantly in recent years. The growing number of people sensitized to pollen, the variety of symptoms and the negative impact on the quality of life of patients make pollen allergy one of the major problems in pediatrics. Despite the development of international national protocols and clinical guidelines, in many countries the control of allergic rhinitis in children remains insufficient. Therefore, it is necessary to take into account the individual characteristics of patients, pay attention to both nasal and extranasal symptoms, consider all pathognomonic diagnostic aspects, because the underdiagnosis of this allergic disease leads to inadequate therapy, complications, more severe atopy and reduced quality of children’s life in general. Recently, there is growing evidence of the need for personalized selection of the most effective therapy for allergic rhinitis in children. In-depth study of the pathogenetic role of circadian molecular clock in children with seasonal allergic rhinitis using informative molecular genetic methods may allow characterizing in detail the mechanism of regulation of allergic inflammation of the upper airway mucosa and evaluating the role of circadian genes in the development of allergic diseases, in particular allergic rhinitis. In the future, these studies may become an alternative to improve control over the course of allergy and the organization of a comprehensive monitoring system, development of new strategies for the treatment and prevention of allergic rhinitis in children.

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The high prevalence of seasonal allergic rhinitis (SAR) among children continues to rise steadily. However, there is not only an increase in the frequency of allergy, as an independent nosology, but also its combination with other atopic diseases. It should be noted that the comorbidity of SAR with asthma, allergic conjunctivitis, atopic dermatitis significantly impairs the daily activities and quality of children’s life. Purpose - to study the peculiarities of seasonal allergic rhinitis in children on the background of comorbidities depending on the age of the patient and to analyze the structure of pollen sensitization taking into account the retrospective results of skin allergy testing. Materials and methods. For a retrospective study, 890 case histories of children with SAR aged 3-15 years from 2010 to 2020 were selected and analyzed. The inclusion criteria were children with positive skin allergy testing for at least one pollen allergen in the test panel. During the analysis, patients were divided into three age subgroups: preschool children (3-6 years), primary school age (7-10 years) and middle school age (11-15 years). Results. Our results show that the comorbidity of SAR depended in some ways on the age of the child. Thus, among children of the first group the combination of SAR with recurrent obstructive bronchitis and atopic dermatitis was mostly often registered, while in patients of the second and the third groups - with allergic conjunctivitis and asthma. It was also found that the clinical picture of the disease did not differ significantly from the patient’s age and was characterized by moderate severity of allergic rhinitis. The study of the spectrum of sensitization to pollen allergens revealed a significant prevalence of children with hypersensitivity to ragweed allergen. It was found that more than a third of preschool and primary school children were also more likely to be sensitive to wormwood and corn, while middle school children - timothy, fescue, wormwood, ryegrass and cyclachaena. Conclusions. Therefore, the study allowed to establish the features of the clinical course, severity, combination of SAR with other diseases and identify the most etiologically significant pollen allergens, which are a priority in the occurrence of seasonal allergic rhinitis in children of Poltava region. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: children; seasonal allergic rhinitis; clinical and diagnostic features; sensitization spectrum.

Since allergy pathology in the structure of general somatic diseases occupies a significant niche in both adult and child populations and is accompanied by a number of unresolved issues, it represents a major medical and social problem. The use of modern diagnostic techniques has made it possible to broaden scientists’ knowledge of the in-depth mechanisms of the pathogenesis of allergic diseases with the subsequent development and implementation of new diagnostic, therapeutic and prophylactic recommendations. However, the multidisciplinary aspects of paediatric allergy continue to be studied; among them, the problems of specific diagnosis of food allergy are of particular importance. Recently, the study of allergic lesions in the various parts of the gastrointestinal tract has received increasing attention in paediatric practice. Since in most cases the mucosa of the digestive system is the first to contact with allergens of various nature, the gastrointestinal form ranks second in the overall structure of clinical symptoms of food allergy. Gastrointestinal symptoms of food allergy are characterized by polymorphic manifestations, making timely verification of the diagnosis difficult. This leads to prolonged differential analysis and requires the exclusion of concomitant organic and functional gastrointestinal pathology, which delays early diagnosis and timely therapeutic recommendations for patients with food allergy. The relevance of the above-mentioned problem is highlighted by the following clinical case.

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