Beş yaş altı çocuklardaki kronik öksürük etyolojisinde süt çocuğu geçici hipogamaglobulineminin araştırılması

Kronik öksürük, çocukluk çağının en sık doktora başvuru şikayetlerinden biridir. Amerika Göğüs Hekimleri Derneği kronik öksürüğü dört haftadan daha uzun süren öksürük olarak tanımlamaktadır. Etyolojide solunum yolu enfeksiyonları, gastroözefageal reflü, persistan bakteriyel bronşit, astım, kistik fibrozis, konjenital malformasyonlar, yabancı cisim aspirasyonu gibi birçok neden yer almakla birlikte süt çocuğunun geçici hipogamaglobulinemisine yönelik çalışma bulunmamaktadır. Bu çalışmada kronik öksürük etyolojisinde süt çocuğunun geçici hipogamaglobulinemisinin rolünü vurgulamayı amaçladık. Çalışmaya Ocak 2015 - Aralık 2020 tarihleri arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Çocuk Göğüs Hastalıkları polikliniğine beş yaş altı kronik öksürük şikayeti ile başvuran öksürüğün diğer nedenleri ekarte edilen ve retrospektif olarak dosyasına ulaşılabilen süt çocuğunun geçici hipogamaglobulinemisi kriterlerini karşılayan 55 hasta dahil edildi. Hastaların demografik özellikleri, başvuru laboratuvar değerleri, IgG başvuru ve düzelme anı değerleri, düzelme süresi, boy - kilo persentil değerleri, hastane yatış, takipte aldıkları

Chronic cough is one of the most common complaints of childhood that leads to consulting a doctor. The American College of Chest Physicians defines the chronic cough as a cough that lasts longer than four weeks. Although there are many causes such as respiratory tract infections, gastroesophageal reflux, persistent bacterial bronchitis, asthma, cystic fibrosis, congenital malformations, foreign body aspiration in the etiology, there is no study on transient hypogammaglobulinemia of infancy. In this study, we aimed to investigate the role of transient hypogammaglobulinemia of infancy in the etiology of chronic cough. Fifty-five patients who were admitted to the Necmettin Erbakan University Meram Medical Faculty Pediatric Chest Diseases outpatient clinic between January 2015 and December 2020 with the complaint of chronic cough under the age of five, whose other causes of cough were excluded, and whose files could be accessed retrospectively, were included in the study. Demographic characteristics of the patients, laboratory values at admission, immunoglobulin G (IgG) levels at admission and after recovery time, recovery time, height-weight percentile values, hospitalization rates, and treatments during followup were analyzed. SPSS 25.0 program was used for statistical analysis. p<0.05 was considered significant. In our study, 35 (63.6%) of the cases were male and 20 (36.4%) were female (n: 55). The mean age at admission was 21.73 ± 11.50 months, the mean age of recovery was vii 38.65 ± 16.81 months, and the mean time to recovery was 16.93 ± 12.85 months. There was a history of consanguinity in 22.4% of the patients, prematurity in 23.4% and a sibling with frequent illnesses in 18.2%. The most common complaint accompanying chronic cough in patients was frequent respiratory tract infection with 16.3%. In laboratory values, along with IgG, 26.4% of the patients had low IgA and 31.5% had low IgM levels. In antibody responses, isohemagglutinin, anti tetanus, anti pneumococcal, anti Hbs vaccine responses were found to be positive in 90.6%, 63.9%, 66.7%, and 97.7% of the cases, respectively. 72.7% of the patients received inhaler treatment, 45.5% antibiotic prophylaxis, and 2.2% intravenous immunoglobulin treatment. The mean hospitalization for lower respiratory tract infection was 2.43 ± 2.62, the mean number of bronchiolitis was 2.70 ± 2.87, the mean duration of inhaler treatment was 7.38 ± 10.1 months, and the mean duration of antibiotic prophylaxis was 55 ± 9.43 months. It was observed that there was no difference in the number of hospitalizations due to lower respiratory tract infection, the number of previous bronchiolitis, the duration of inhaler treatment, the duration of antibiotic prophylaxis and the recovery period according to the age groups of the patients (p>0.05). Again, there was no correlation between the recovery time and the difference in IgG levels related to age groups and prematurity (p>0.05). There was no difference in the number of hospitalizations according to the height-weight percentiles at admission (p>0.05). After IgG values returned to normal, 86.3% of the patients were found to have a cough complaint. Transient hypogammaglobulinemia of infancy is a low level of immunoglobulin that starts in infancy and usually resolves at 2 - 4 years of age. Patients mostly present with recurrent lung infection where cough is a symptom and lasts for a long time. In our study, the improvement of the cough complaints of the patients who presented with chronic cough and were found to have transient hypogammaglobulinemia of infancy when the immunoglobulin values returned to normal should also make us think of transient hypogammaglobulinemia of infancy in the etiology of chronic cough in children under the age of five