[FAMILIAL MEDITERRANEAN FEVER IN CHILDREN: ENDOSCOPIC CONDITION ОF THE GASTROINTESTINAL TRACT IN DIFFERENT PERIODS OF THE DISEASE].

Family Mediterranean fever (FMF, Periodic disease) is a hereditary autosomal recessive disease and belongs to orphan diseases. Abdominal pain syndrome in this pathology is accompanied by various complaints from the gastrointestinal tract. The aim of the study was to study the state of the gastrointestinal tract in children with FMF. We observed 66 children aged 4 to 18 years with genetically confirmed FMF. The most frequent complaints were complaints of vomiting - 33.3% of cases and liquefied stools - 24.2% and nausea - 16.7% of cases. Erosive changes in the upper gastrointestinal tract were most often observed in the esophagus (up to 15.4%) during the attack and outside it. In endoscopic examination of the colon during the attack, changes in CO were significantly more common.

[NEW METHODS AND PERSPECTIVE APPROACHES TO FOOD ALLERGY THERAPY IN CHILDREN].

The purpose is to analyze literature data on currently used and promising approaches to the treatment of food allergies in children. It reviewed the variants of allergen-specific food allergy therapy (AST-FA), which allow expanding the range of consumed products to which no reaction is manifested, reducing the risk of developing potential life-threatening allergic reactions if they are accidentally ingested. AST-FA is currently the only potentially effective method of IgE-mediated FA. One of the new options for pathogenetically substantiated therapy of FA is the use of biological drugs that increase the ability to achieve immune tolerance to food antigens. It seems reasonable to consider the possibilities of using a number of non-allergen-specific molecules - cytokines, Toll-like receptors, various cell populations, probiotics and gene therapy - as potential targets for treating patients with multiple food allergies. Further studies are needed to determine the optimal dose, duration of treatment, and long-term effects of biologics used in the treatment of FA.

FOR EXTRAINTESTINAL MANIFESTATIONS OF INFLAMMATORY BOWEL DISEASE IN CHILDREN.

Inflammatory bowel disease (IBD) are systemic diseases with different intestinal and extra-intestinal manifestations (ElM). This fact can determin an examination plan and the disease course and prognosis. Up to 8.4% of children with IBD have ELM like the first symptom of the disease. The range of ElM of iBD in children is differ from that one of adult patients: rarer arthropathy and arthritis, skin and liver diseases, an extremely rare eye disease. The physical development disorder is a typical children's manifestation of the IBD, the "failure of the weight curve" is an early symptom of the IBD debut (82% of examined children), especially ulcerative colitis. The article discusses the clinical features and therapy of the most frequent extraintestinal manifestations of IBD in children: skin, mucous, eye diseases, axial and peripheral arthropathies, primary scierosing cholangitis, physical, sexual development disorders, decreased bone mineral density. Most often, we observed patients with arthritis and primary scierosing cholangitis - up to 12.5% of patients with active disease. A growth failure was observed in 20% of children with IBD debut, and remained in 9.7% children despite adequate anti-inflammatory therapy. Decreased bone mineral density in children with IBD observed in 30% cases (ISCD-recommendations). Extraintestinal manifestations are very important to make the early diagnosis of IBD without any intestinal symptoms. The pediatrician can suspect a systemic diseases course. ElMs adversely impact upon patientsquality of life and some can be life-threatening.

[COMORBIDITY AND POLYMORBIDITY IN ADULTS AND CHILDREN IN THE LIGHT OF THE PROBLEM OF NSAID-GASTROPATHY].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most demanded drugs. Paper presents the data review on the drug activity mechanisms, effectiveness, safety, and major drug interactions of NSAIDs at co-morbid conditions in different age groups, as well as measures of prevention of NSAID-gastropathy, which can occur even against the use of small doses of NSAIDs. The existing recommendations on the selection of NSAIDs and the complex therapy with drugs of this pharmacological group are shown in considering the individual characteristics of the patient, the pharmacological properties of drugs, the clinical picture of the disease, the presence of risk factors for adverse reactions and drug interactions.