N.V. MALININA, T.N. MALYUGINA

 Saratov State Medical University named after V.I. Razumovsky, Saratov

Contact details:

Malinina N.V. — Assistant Lecturer of the Department of Infectious Diseases in Children and Polyclinic Pediatrics named after N.R. Ivanov

Address: 112 Bolshaya Kazachya St., 410012 Saratov, Russian Federation, tel.: +7-927-109-33-59, e-mail: malinina-nv@mail.ru

Children with acute respiratory viral infections (ARVI) develop various topical catarrhal respiratory syndromes regardless of the etiological factor. However, it is currently not clear what determines the development of a particular syndrome in children with acute respiratory viral infections. Hence, the search continues for adaptive markers that determine the course of acute respiratory viral infections.

The purpose — to characterize the adaptation process and identify its variants based on hormonal parameters in children with acute respiratory viral infections.

Material and methods. There were 263 children aged 1 to 10 years in the acute period of acute respiratory viral infections. In addition to the standard clinical, laboratory and instrumental examination, the levels of thyroid hormones (T4 free, T3 free), thyroid-stimulating hormone of the pituitary gland (TSH), and cortisol in the blood serum were determined.

Results. According to our results, we propose three variants of the adaptation process in children with acute respiratory viral infections: reactive, hyporeactive and hyperreactive. The reactive variant developed in patients with a smooth course of acute nasopharyngitis, acute laryngotracheitis and acute bronchitis and was accompanied by minimal changes in hormone levels. The hyporeactive variant was found in patients with acute obstructive laryngitis and acute obstructive bronchitis and was accompanied by low cortisol levels compared with other acute respiratory viral infections. The hyperreactive variant was characterized by high levels of cortisol, TSH, and low levels of T3free. It was accompanied by pneumonia.

Conclusions. Due to the revealed low levels of cortisol in the blood serum, for children with a hyporeactive variant of the adaptation process, one consider using not only inhaled glucocorticoids, as indicated in the clinical recommendations, but also parenteral glucocorticoids. According to the results obtained, therapy with glucocorticoids is not indicated for children with a hyperactive variant of the adaptation process.

Key words: adaptation, cortisol, thyroid-stimulating hormone of the pituitary gland, triiodothyronine, acute respiratory viral infection, children

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