Dust bronchial asthma is a clinical variant of the atopic form, due to sensitization to house dust allergen. In contrast to foodborne dust bronchial asthma develops after 5-7 years (97%) and is observed mainly in school-age children (86%). According to our data, it accounts for 11.35% of all clinical variants of bronchial asthma (table 4.11). Its development is preceded by allergic rhinitis, which subsequently is 100% combined with it. Attacks always begin acutely, against the background of full health, mainly at night, are repeated after 1-3 months, are short-lived (in 72%, no more than a few hours), are quickly stopped by taking bronchospasmolytic drugs and after separation from the home environment (high elimination effect). Attacks of suffocation occur year-round only at home, are not associated with food intake, there is no seasonality. The entrepreneurial period occurs in the form of itchy nose, rhinorrhea, paroxysmal sneezing.
Premorbid background in patients with dust asthma is characterized by a rather high frequency of hereditary and constitutional predisposition to allergies (63 and 54%), atopic dermatitis is very rare (5%). Pathology of the ante- and intrapartum periods (25%), poor nutrition of a pregnant woman (15%) and early transfer to mixed and artificial feeding (22%) are not characteristic, diseases of the digestive tract are rarely detected (29%). The history of previous respiratory diseases is detected in almost all patients.
Thus, dust and food bronchial asthma are clearly distinguished by clinical signs. Having carried out an analysis of asthma symptom frequency indicators together with T.V. Klykova using Bayes’ theorem (L. Lasted, 1971), the main symptoms were selected for each of them (table 5.7). Knowledge of these signs is very important for making an etiological diagnosis, since the specific treatment of these two clinical options is completely different. The main thing in the treatment of food-borne asthma is the temporary exclusion from the diet of patients with allergenic products by prescribing individual elimination diets with the subsequent expansion of the diet, while the leading treatment for dust bronchial asthma is specific immunotherapy with house dust allergen. Both methods are highly effective; they allow achieving a long and stable remission of the disease and often recovery of patients.