Anomaly of constitution.
The diathesis (anomaly of the constitution) is change is functional condition of neuroregulation
mechanisms, instability indicators of biochemical individualities because of ability of adaptation of
an organism to environment changes.
The general reasons of development of anomalies of the constitution
• geterochronism in maturing of organs elements of blood, enzymes and functions of a liver, kidneys
and other
• defect, delay and a distortion of the immune answer
• hypo- and discortical, leading to disregulation of endocrine, metabolic and immune process.
Risk factors of formation of anomalies of the constitution
• the burdened heredity factor
• chronic diseases of the pregnant woman, reception of medical products
• a bad food of mother during time of pregnancy
• adverse factors during pregnancy and delivery
• infectious diseases of the pregnant woman, wrong feeding
THE GENERAL CLINICAL DISPLAYS OF ANOMALY OF THE CONSTITUTION
• adaptation defect, both functional, and social;
• decrease in all protective forces of an organism and reccurent disease;
• RTI, proceeding with obstructive component;
• bronchial asthma;
• exudative and other rashes on skin;
• increase in lymph nodes, tonsil, adenoid;
• metabolic defect, para- or a dystrophy
CLASSIFICATION OF THE DIATHESIS
• 1. Allergic and immune:
- atopic; autoallergic; a lymphatic.
• 2. Exchange, dismetabolic:
- The diabetic;
• 3. Organotopic:
•
- nephropatologic, cardiopathologic, hypertensive, aterosklerotical.
• 4. Neurotopical:
•
- Psycho-neurotic, vegeto-distonical.
In family doctor's practice the genetic diseases have a great sense. Heritable pathology has nonspecific clinical signs at the first stage which classified like diathesis or anomaly of constitution.
There are exudat-cataral, lymphatic-plastic and nerve-arthritic anomaly of constitution. The
diagnosis of diathesis sets with child's bloodline, the character of pregnancy, laboratory tests.
Exudative-cataral diathesis is frequent anomaly of constitution. About 28% of children
have eithers clinical signs of diathesis. They develope from hereditary dislocations of some
zymolysises. Histaminepectical ability of blood is low, activity of carbocsy-pepthydase is small. The
children which have exudative-cataral diathesis natrium, chlorine, water and organic amines repose.
It is disbalance working of adrenals. The children' relatives with exudat-cataral diathesis have
allergy diseases such as bronchial asthma, polynosis, nutritive allergy. Exudative-cataral diathesis
characterises catarrh of epithelial canals and allergy skin which has addiction to the second
microbial infection. Exudative-cataral diathesis may be in the first months children' life, condition of
an organism of the child, tendancy skin and mucous, for infiltrative and desquamation process
(infantale epitheliopathy), lymphoid hyperplasia, electrolite balance, tendancy for allergic reactions,
inflannatory and to infections disease.
Exudative-cataral diathesis characterizes:
 Gneiss» (seborretic crests on a head);
 Scaling of skin on buffale and skin foles;
 Crythene and infiltration of skin of cheeks («A dairy scab»);
 Erithema of open parts of a body ;
 Itching a nodular rash (strophulus) on limbs;
 «Geographical» tongue;
 Various allergic rushes;
 Decrease turgor of skin;
 Paratrophy, an "unstable" curve of an increase of weight;
 Micropolyadenia;
 Unstable a stool;
 Blepharitis, otitis, conjunctivitis, rhinitis;
 Obstructive bronchitis
Children have blepharitis, conjunctivitis, catarrhs of high respiratory, vulvavaginities,
balanitis, infection of uric canals from the side of mucous membrane. The children have diarrhea or
constipation. When the children are surveyed in laboratory they have conservative leucocytosis,
eozinophily, lympho- and monocitosis. It is important to elevate immunoglobulin E in blood, to
shave immunoglobulin A in mucous membrane.
Prophylaxy of exudative-cataral diathesis begins long before child's born and based on development
expectant mother's hypoallergy mode of life. The children with anomaly of constitution have to be
on breast-feeding more longer.
Treatment: a hypoallergenic diet fn with an expection of all allergens, cows milk, meat, fish,
vegetables, fruits; when the allergy appears the antihistamines appoint to the child (suprastinum,
tavegilum, ketotephinum). The base of pathogenetic treatment exudat-cataral diathesis is elevation
epithelium of digestive tract for proteins, thus these children have to treat by membraneprotective
medicines (vitamins A, E, B6). Intensive syndrome at exudat-cataral diathesis results in
development disbacterioce of intestine as a rule. Thus we have to apply bacterial medicines
(biphido-bacterinum, lacto-bacterinum, koly-bacterinum) and also feeding by milk products.
Phitotherapy is the treatment of dermal and digestive diseases exudat-cataral diathesis. Ointments
obtain overskin which containt zinc and papaverine, Unna's cream.
Lymphatic-hypoplastic diathesis is fall of glucocorthycoid function adrenals, inadequacy
of immunocompetent function adrenals, inadequacy of immunocompetent function lymphatic tissue.
The anomaly constitution accompaned diffused hyperplasia of lymphoid organ generalised
lymphoadenopathy and thimic hyperplasia) dysfunction of endocrine system, change in immune
status of child to external conditions.
Clinical symptoms:
- large birth weight, edema;
• decrease in weight;
• decreased turgor of skin and muscular tone;
• wealcnels, fatigue, decrease in blood pressure;
• rashest on skin;
• treatment respiratory illness;
• a disproportional constitution, distribution of subcutaneous fat (more or lower part of
body);
• peripheral lymph edema, splenomegaly, thymomegaly;
• multiple signs of dysenbriogenesis: hypoplasia of heart and majorveuels, kidneys, external
genitals, endocrineglasels, and minor development anomalied;
• absolute and relative lymphocytisis, nephrocytopenia, monocytopenia;
• decrease in concentration of glucose, increase of cholesteral and phospholepids;
• decrease IgA, IgG, T- and B-lymphocytes disproporcion of T-help. and N-sup., increased in
concentration of circulatory immuno complex;
• decrease in conctntration of thymic factory (T-cells) and 17-hydrochlore in urine.
Children' relatives with anomaly of constitution have chronic disease of nasopharynx and
respiratory tract. The children look half-hearted, pasty, the mass of the body tops middle-normal
marks. Hypodermic-adipose cellular tissue is sick, muscular system is redundatly. The body is
small, extremities are long, thorax is narrower. Tonsiles are hypertrophied and crumbly. The ill
children have addiction to frequent respiratory diseases. The syndrome of sudden death may be at
stress. Children' blood has small leucocytosis, small or absolute lymphcytosis, sometimes
monocytosis.
Treatment: it is recommended to harden, to attend massage and gymnastic. The ill children
is reccommended to take vitamins (Aevit, Undevit, Alphabet and others) which content vitamins A,
E, C, B. Also we have to do sanitation of nasopharynx both children and adults.
Neuro-arthritic diathesis has the base on genetic determine infraction of active ferments,
which take part in the process of synthesis uric acid, genetic defect of metabolism, first of all uric
acid and purine bases, clinical features of these defect is increased stimulations of CNS, spastic and
allergic symptoms. Children' bloodline has podagra, gravel, gallstone disease, osteohondrosis,
hypertensive disease, sick headache. Nerve-arthritic children have low mass of the body, but it may
be high.
Clinical manifestation
Poor family history (with idential frequerency - 18-22%) gout, urolithiasis, diskinesia of bile
duct, atherosclerosis, ischemic desease of heart, hypertension and disease, metabolic arthritis,
frequent upper respiration illness. Disease of duodenum;
 In the first months of a life – poor weight gain, loose stools (mild hypotrophy, in puberty
obesity).
 Mild lymphopolyadenopathy.
 Various defect in protein and carbohydrate metabolism (decompensation at school age stress,
charge of food, and physical over activity);
 Neuro syndromes (frequeres 84 %):
- first year – hyper excitability, cry, poor sleep, instability, fear;
- early mental and emotional development baby speak, good memory, start reading early;
- emotional lability (sleep bad, anorexia, tics, cough, habitual voming, aerophagia,
enuresis.
Treatment: The base of pathogenetic treatment is elevation epithelium of digestive
tract for proteins, thus these children have to treat by membrane protective medicines. Phitotherapy
is the treatment of dermal and digestive diseases nerve-arthritic diathesis. Ointments obtain over
skin which containt zinc and papaverine. The ill children is recommended to take vitamins (Aevit,
Undevit, Alphabet and others) which content vitamins A, E, C, B. Also we have to do sanitation of
nasopharynx both children and adults.
Treatment principles:
• Food according age with restriction of fried, stewed, carned meat, sausages, smoked
products, hot dishes, coffee, cocoa, citrus, spinach, radish, cauliflower, green peas.
Vegetative and dairy products can begined to the patient, meat and fish - soup. If pacient is
on strictied no need of treatment.
• at inmetabolic (aceton) vomiting - hunger for 12 o'clock, then small portions (1-2 teaspoons)
5 % glucose, nail solutions. If condition improvement - smashed potatoes, a banana. In sever
cases intraveron fluids.