Features of microcirculation changes in children with a burdened allergic history. Case Report

Abstract

Microcirculatory changes play an important role in the pathogenesis of allergic diseases. The definition of microcirculation includes the movement of fluid between the circulatory and lymphatic networks through intracellular systems, the transmembrane exchange of substrates, gases, including metabolic products and signal molecules. Due to the complexity of the pathogenesis of microcirculatory changes, it is necessary to use sensitive methods for diagnosing the degree of capillary blood flow disorder and associated changes in the microvessels of the arteriolar and venular parts of the microvasculature. Today, there is an available non-invasive method for assessing microcirculation using capillaroscopy of the nail-fold, which allows assessing the structure of microvessels in real time in vivo. Evaluation of capillaries by nail-fold capillaroscopy is the safest method for children and does not cause them concern during the study. With the help of capillaroscopy of the nail-fold, it is possible to assess the quantitative parameters of microcirculation, the width and length of the capillaries, the diameter of the arterial and venous sections, the outer and inner diameters, the width of the apex and the distance between the capillaries. The speed of blood flow in the arterial and venous sections is also taken into account. It is important to note that capillaroscopy also assesses the presence of avascular zones, the appearance of which indicates tissue hypoxia, and therefore can be considered as an important prognostic factor. Capillaroscopy is of great diagnostic value, as it allows developing tactics for treating patients, and, most importantly, assessing the effectiveness of the therapy and predicting the outcome of the disease. The presented clinical observation convincingly demonstrates the need to assess microcirculation during nail-fold capillaroscopy in children with aggravated allergic anamnesis.