Etio - pathogenic aspects and complex conservative treatment of chronic tonsillitis in children

Abstract

Background: Considering the role of palatal tonsils in the human body, medical professionals exercise cautiousness when considering tonsillectomy, especially in children, when the tonsil’s physiological function is at its highest. Use of new diagnosis methods for measuring local and systemic immunity reactions, in correlation with a clinical evolution of the disease, will allow us in the future to gain in-depth knowledge about certain etiopatogenetic aspects of chronic tonsillitis. Objective: 1.To explore some aspects of systemic immune reactions in chronic compensative tonsillitis. 2.To compare systemic immune reactions in chronic tonsillitis and adults. 3.To explore the efficacy of complex conservative treatment of children with compensative chronic tonsillitis. Subjects and methods: 24 children and 13 adults with chronic compensative tonsillitis – imunological examinations, 180 children who were treated with conservative methods. Outcome measures: C-reactive protein, antistreptolysin O, absolute and relative amount of B lymphocytes, immunoglobulins – A, M, G, circulatory immune complexes, interleukins IL-4, IL-8, IL-1β in blood serum. Results: Interleukin-8 is 6.5 times higher in children than in adults (p=0.047), interleukin - 1 β is 17.4 times higher (p=0.045). Serum levels of IgA in adults is higher than in children (p=0.038), antistreptolysin – O titre is 1.4 times higher. We obtained positive results in 85% of cases treated with conservative methods. Conclusion: The study of interleukin – 1 β and interleukin – 8 is useful in understanding the etiopathogenetic mechanisms of chronic compensative tonsillitis in children. Nonspecific immune factors play an important role in the immune response in chronic tonsillitis in children, while in adults the main role is held by a specific immune response. The dispanserisation of the children with chronic compensative tonsillitis and the complex conservative treatment, that include local and general immunostimulation, will decrease the number of complications and will improve the quality of life.