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CHAPTER 4. EARLY CHILDHOOD DISORDERS

In the first three years of their life, children are most susceptible to various diseases most of which are associated with malnutrition, improper care, and low physical activity. Malnutrition, especially in young children, leads to persistent metabolic changes aimed at maximizing energy conservation. Therefore, in subsequent years the child may develop serious nutritional and metabolic diseases, such as atherosclerosis, hypertension, metabolic syndrome, etc. Physicians attach great importance to constitutional anomalies that are not considered disease but a predisposition to disease, since proper organization of daily routine, care and nutrition play the most important role in the management of patients with these conditions.

CONSTITUTIONAL PREDISPOSITION

Diathesis is constitutional predisposition to a disease. More than 17 types of diathesis have been described. Exudative-catarrhal, lympho-hypoplastic, neuro-arthri-tic, allergic, hemorrhagic diatheses are most studied.

Diathesis (from Greek: propensity, predisposition) is predisposition to certain diseases or inadequate reactions to ordinary stimuli. Thus, diathesis is not a disease per se, but only a predisposition to its development.

Exudative-catarrhal diathesis

Exudative-catarrhal diathesis (ECD; synonym: atopic diathesis, lymphatism) is a constitutional anomaly characterized by predisposition to prolonged inflammation and allergic reactions, lymphoid hyperplasia, unstable water-salt metabolism, and infiltrative desquamation in the skin and mucous membranes.

Etiology and pathogenesis

The most important part of the pathogenesis of ECD is allergy. It is well known that at an early age, sensitization occurs mainly through food. Food allergens are represented by proteins and their combinations with carbohydrates and fats, additives that improve the organoleptic properties of food (usually dyes, preservatives, flavoring, emulsifiers), fertilizers and pesticides in vegetables, fruits and cereals, nickel in polymer and metal packaging, mold, etc. (table 4.1, 4.2).

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