Allergy history: features of collection, principles and recommendations. Allergy history, the purpose of its compilation and the process of collecting information Allergy history is calm

Introduction

Drug and drug allergies (LA) is a secondary increased specific immune reaction to drugs and medications, accompanied by general or local clinical manifestations. It develops only after repeated administration (contact) of drugs. Upon initial contact, antibodies and immune T cells appear. Moreover, T-lymphocytes are able to recognize drugs - haptens, as a result of which T-cells are formed with specific alpha-beta and, less often, gamma-delta receptors, hapten-specific clones of which are isolated in vitro. Among them were Th1, Th2 and CD8 T lymphocytes. Pseudoallergic reactions to drugs are nonspecific (without antibodies) increased reactions to drugs that are clinically identical to allergic reactions.

There are two categories of patients with this allergy. In some, LA occurs as a complication during the treatment of some disease, often allergic in nature, significantly aggravates its course, and often becomes the main cause of disability and mortality. For others, it is an occupational disease, which is the main, and often the only cause of temporary or permanent disability. As an occupational disease, LA occurs in practically healthy individuals due to their prolonged contact with drugs and medications (doctors, nurses, pharmacists, workers at medical drug factories).

Drug allergy (DA) occurs more often in women than in men and children: among the urban population in 30 women and 14.2 men per 1000 people, and in the rural population, respectively, in 20.3 and 11 per 1000. LA is more often observed in individuals at the age of 31-40 years. In 40 - 50% of cases, antibiotics were the cause of allergic reactions.

Mechanisms of drug allergy include immediate, delayed and pseudo allergic reactions. Therefore, their clinical manifestations are varied, which makes diagnosis difficult, especially in patients with allergies to many drugs, multiple drug allergies(MDAS).

Whenever side effect medications and medications needed:

Determine whether the reaction to them is allergic;

Identify the causative allergen drug and establish a diagnosis.

Main diagnostic criteria for LA:

1. Presence of anamnesis and characteristic clinical manifestations.

2. Paroxysmal, paroxysmal course and rapidly occurring remission when drugs are eliminated; on the contrary, a sharp aggravation in case of repeated use.

7. Identification of allergen-specific T-lymphocytes (especially in PCCT).

8. Positive skin allergy tests with a specific allergen.

9. The effectiveness of nonspecific antiallergic (antihistamines, etc.) therapy.

Diagnostic criteria the following signs serve: 1) establishing a clear connection between clinical manifestations and medication intake; 2) mitigation or disappearance of symptoms after withdrawal; 3) history of allergies; 4) good tolerability of the drug in the past; 5) exclusion of other types of side effects (toxic, pharmacological, etc.); 6) the presence of a period of sensitization - at least 7 days; 7) similarity of clinical symptoms with manifestations of allergy, but not with another effect; 8) positive allergological and immunological tests.

Table 1. Relationship between the clinical picture and diagnosis of drug allergies and pseudo-allergies with the types of allergic reactions
Reaction type	Mechanism	Clinical manifestations	In vitro and in vivo diagnostic tests
Immediate
- anaphylactic	Antibodies IgE, IgG4	Shock, urticaria, etc.	Determination of IgE, IgG4 antibodies in blood serum and fixed by basophils. Skin, sublingual and other tests
- cytotoxic	Antibodies IgG, IgM	Hematological, etc.	Determination of IgG, IgM auto- and hapten-specific antibodies in blood serum
- immunocomplex	IgG antibodies, IgM, immune complexes	Serum sickness, vasculitis	Determination of IgM and IgG antibodies, identification of immune complexes. Skin and other tests
- granulocyte-mediated	IgG, IgA antibodies associated with granulocytes	Any clinic	Reactions of release of potassium ion mediators and enzymes from granulocytes. Skin and other tests
- antireceptor reactions	IgG and IgM antibodies	Autoimmune reactions	Antibodies against cell receptors, cell stimulation or inhibition
Slow reactions	Immune T lymphocytes	Contact dermatitis, organ damage	Detection of immune T-lymphocytes Skin and other tests after 24-48 hours
Mixed	Antibodies IgE, IgG and T lymphocytes	Various combined, photosensitivity	Determination of antibodies and immune T cells. Skin and other tests
Pseudoallergy	Nonspecific	Any	Assessment of leukocyte activation and alternative complement pathway by inducing agents

1. Allergy history

When collecting a drug allergy history, special attention is paid to drug tolerance and possible sources of sensitization to them, taking into account the fact that there may be hidden contacts. Therefore, in addition to the usual allergy history, it is necessary to find out the following.

1. Hereditary predisposition: the presence of allergic diseases (BA, urticaria, hay fever, dermatitis, etc.) in blood relatives.

2. Whether the patient was previously treated with any drugs, whether there were reactions to them and how they manifested themselves: whether drugs were used (orally, subcutaneously, intravenously); were there multiple courses; have there been any reactions to ointments and drops; were vaccines and serums administered, were they adverse reactions; what they were expressed in; is there a connection between intolerance to various medications, vaccines and eggs, etc.; available (had) fungal diseases and whether there is a connection with antibiotic intolerance.

3. Is there any professional contact with medications and with which ones; whether there were any allergic reactions to them; whether they become more acute at work and lessened outside of it; whether the symptoms of other diseases are getting worse.

4. Is there any connection with other types of allergies: presence food allergies; tolerance to food additives (tartrazine), drinks, etc.; are there any chemical, household or professional allergies; whether there is hay fever, asthma or other allergic diseases.

5. Previous allergic diseases suffered by the patient (shock, rash and other reactions to food, medications, serums, vaccines, insect bites and others, what and when).

Conclusion:

1) the medical history is complicated and there is a connection between the disease and allergens (an allergological examination is necessary);

2) the medical history is not burdened and there is no connection with the action of allergens (does not require examination by an allergist).

If there are clear indications in the anamnesis (or records in the medical history) of an allergy to the drug, then it and drugs that have cross-reacting common determinants should not be administered to the patient and provocative tests (skin tests, etc.) with this drug are not recommended. Laboratory testing is possible. It is extremely necessary if the anamnesis is unclear (the patient does not remember what drug the shock was taken on) or it cannot be collected (unconscious state).

IN acute period allergic disease Specific tests are often negative, and allergen testing in patients may exacerbate exacerbations. Therefore, such examination is usually carried out during remission. An alternative to testing on a patient is a laboratory examination.

Allergy examination includes two types of methods: 1) laboratory methods which should precede tests on the patient; 2) provocative tests on the patient.

When assessing the examination of a patient, you should always remember that if the laboratory and/or provocative test is positive, the patient may have a reaction to the test drug and its replacement is necessary. When negative tests(especially if one is placed) the possibility of a reaction cannot be ruled out.

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Data for allergy history

Allergic conjunctivitis

The ophthalmologist collects an allergy history in the same way as when examining a patient with any other diagnosis. The questions asked concern the topic of eye allergies and common allergic reactions. There are a lot of reasons for allergies, so it is important to create a survey correctly, without missing out on the smallest details and moments.

Collect information such as:

identifying a direct connection between the onset of the disease and exposure to a certain factor;
determination of hereditary factors, the presence of pathologies in close and distant relatives;
clarification of influence environment(weather, climate, seasonality) on the development of the disease;
the influence of domestic causes (dampness, presence of carpets, pets);
correspondence of connections between diseases of other organs;
identification of hazardous working conditions;
identifying reactions to medications;
consequences of physical overload and negative emotions;
influence past diseases infectious and colds;
list of food products that can cause allergies.

Based on the information obtained, it is possible to preliminarily establish the causes and factors influencing the manifestation of any allergic reaction.

Allergy history, allergic eye diseases

Even medications can become an allergen

The form of any allergy usually begins with rhinitis and redness of the eyes. Most allergies of the eye organ manifest themselves in the form of eyelid dermatitis and inflammation of the conjunctiva. The reasons include the use of medicinal eye medications in the form of drops and ointments.

Allergic eye diseases

Allergic conjunctivitis begins with redness of the eyes, inflammation of the eyelids, redness, and itching (blepharitis). Less commonly, inflammation (keratitis) may develop.

The most extreme and susceptible part eyeball, due to its anatomical location, all allergic reactions are reflected in its condition.

Types of allergies:

Allergic dermatitis occurs when there is direct contact between the skin and an allergic substance. Symptoms:

redness of the eyelids and skin around the eyes;
swelling of the eye;
rash on the surface of the eyelids, where the eyelashes are, in the form of bubbles;
the occurrence of itching and irritation.

Allergic conjunctivitis can be acute or chronic. Has the following symptoms:

redness of the surface of the conjunctiva and the eyeball itself;
profuse lacrimation;
the presence of thick and mucous discharge;
in the advanced stage there is glassy edema of the eye mucosa (chemosis).

Hay conjunctivitis develops during the period of abundant flowering of plants and flowers. Available symptoms:

eyes itch and water, turn red;
pain in the eyes, in bright light;
an allergic runny nose and continuous sneezing appear;
paroxysmal suffocation, skin rash on the body.

Vernal conjunctivitis associated with increased dose ultraviolet radiation. Symptoms in a more pronounced form. The surface of the conjunctiva becomes heterogeneous.
Allergy to the lens material and the solution with which they are treated.

Allergy tests

Allergies can manifest themselves in early age

After visiting an ophthalmologist who takes an allergic history, a consultation with an allergist is necessary. He compiles his medical history, takes samples and analyzes the results.

For the allergy test procedure, special solutions containing small particles are produced different types allergen. Scratches are made on the patient’s forearm with special plates and one type of solution is applied, numbered and written down.

After 15 minutes, the doctor examines the patient, his changes in the skin, if there is redness, swelling, this means that there is a reaction to this allergen.

The totality of all actions: medical history, collection of tests and samples gives a clear picture of the disease and its causes. By establishing the cause and eliminating irritating factors, the consequences of the disease can be cured.

What is a denoviral conjunctivitis, the doctor will explain:

Allergic diseases are among the polygenic diseases - both hereditary and environmental factors play a role in their development. I.I. formulated this very clearly. Balabolkin (1998): “According to the relationship between the role of environmental and hereditary factors In pathogenesis, allergic diseases are classified as a group of diseases for which the etiological factor is the environment, but at the same time, hereditary predisposition has a significant influence on the frequency of occurrence and severity of their course.”

In this regard, in case of allergic diseases, the standard medical history scheme is supplemented by the “Allergological history” section, which can be divided into two parts: 1) genealogical and family history and 2) anamnesis hypersensitivity to external influences (allergenic history).

Genealogical and family history. Here it is necessary to find out the presence of allergic diseases in the pedigree of the mother and father, as well as among the patient’s family members.

The following guidelines are important for clinicians: hereditary burden on the mother’s side in 20-70% of cases (depending on the diagnosis) is accompanied by allergic diseases; on the father's side - significantly less, only 12.5-44% (Balabolkin I.I., 1998). In families where both parents suffer from allergic diseases, the rates of allergic morbidity in children are 40-80%; only one of the parents - 20-40%; if brothers and sisters are sick - 20-35%.

And genetic research has provided the basis for a hereditary predisposition to allergic diseases (atopy). The existence of a genetic system of nonspecific regulation of IgE levels, carried out by genes of excessive immune response - Ih genes (immune hyperresponse), has been proven. These genes are associated with the major histocompatibility complex antigens A1, A3, B7, B8, Dw2, Dw3, and high level IgE is associated with haplotypes A3, B7, Dw2.

There is evidence of predisposition to specific allergic diseases, and this predisposition is supervised by different antigens of the HLA system, depending on nationality.

For example, a high predisposition to hay fever in Europeans is associated with the HLA-B12 antigen; in Kazakhs - with HLA-DR7; Azerbaijanis have HLA-B21. However, immunogenetic studies in allergic diseases cannot yet provide specific guidelines for clinicians and require further development.

Allergenic history. This is a very important section of diagnostics, since it allows you to obtain information about the most possible reason development of an allergic disease in a particular patient. At the same time, this is the most labor-intensive part of the medical history, since it is associated with a large number of different environmental factors that can act as allergens. In this regard, it seems appropriate to provide a specific survey algorithm based on the classification of allergens.

Food allergens. Dependence on food allergens should be clarified especially carefully in case of allergic skin diseases and gastrointestinal tract.

It should also be remembered that food allergies are most common in children, especially those under 2 years of age.

“As with other types of allergies, the quality of the allergen is critical in food allergies, but in food allergens their quantity should not be underestimated. A prerequisite for the development of a reaction is exceeding the threshold dose of the allergen, which happens when there is a relative excess of the product in relation to the digestive capacity of the gastrointestinal tract. This is an important thesis, since it allows us to identify patients with various digestive disorders as a risk group and use the correction of digestive disorders in therapeutic and preventive programs for food allergies.

Almost any food product can be an allergen, but the most allergenic are cow's milk, chicken eggs, seafood (cod, squid, etc.), chocolate, nuts, vegetables and fruits (tomatoes, celery, citrus fruits), seasonings and spices, yeast, flour. IN Lately Allergens associated with additives and preservatives that increase the shelf life of foreign-made food products have become quite widespread. If these additives were used in domestic products, they also caused an allergic reaction in persons sensitive to them, and these people served as indicators of the presence of foreign impurities in domestic food. We gave this type of allergy the conventional name “patriotic allergy.”

Cross-allergy is possible within the same botanical family: citrus fruits (oranges, lemons, grapefruits); pumpkins (melons, cucumbers, zucchini, pumpkins); mustard (cabbage, mustard, cauliflower, Brussels sprouts); nightshades (tomatoes, potatoes); pink (strawberries, strawberries, raspberries); plums (plums, peaches, apricots, almonds), etc. You should also focus on meat products, especially poultry. Although these products do not have much sensitizing activity, antibiotics are included in the diet of birds before slaughter, and they can cause allergic diseases associated not with food allergies, but with drug allergies. As for flour, flour often becomes an allergen when inhaled rather than when ingested.

Important in collecting this anamnesis are instructions for heat treatment, since heat treatment significantly reduces the allergenicity of food products.

House dust allergens. These allergens are most significant for allergic respiratory diseases, in particular bronchial asthma. The main allergens of house dust are chitinous cover and waste products of house mites Detmatophagoides pteronyssimus and Derm. Farinae. These mites are widespread in bedding, carpets, upholstered furniture, especially in older homes and old bedding. The second most important allergens of house dust are allergens of mold fungi (usually Aspergillus, Alternaria, PeniciUium, Candida). These allergens are most often associated with damp, unventilated areas and the warm season (April-November); they are also a component of library dust allergens. The third most important in this group are pet allergens, with cat allergens (dander, hair saliva) having the greatest sensitizing ability. And finally, house dust includes insect allergens (chitin and cockroach excrement); Daphnia used as dry fish food; bird feather (pillows and feather beds, especially with goose feathers; parrots, canaries, etc.).

Plant allergens. They are primarily associated with hay fever, and the main place here belongs to pollen, and most often the etiological factor of hay fever is pollen from ragweed, wormwood, quinoa, hemp, timothy, rye, plantain, birch, alder, poplar, and hazel. Pollen from cereals, malvaceae, wormwood, ragweed, sunflower, pollen from birch, alder, hazel, poplar, and aspen has common antigenic properties (cross-allergy). These authors also note the antigenic relationship between pollen of birch, cereals and apples.

Insect allergens. The most dangerous poisons are insects (bees, wasps, hornets, red ants). However, allergic diseases are often associated with saliva, excrement and secretions of the protective glands of blood-sucking insects (mosquitoes, midges, horseflies, flies). More often, allergic diseases associated with these allergens are realized in the form of skin manifestations, however (especially the venom of bees, wasps, hornets, ants) can also cause severe conditions (Quincke's edema, severe bronchospasm, etc.) up to anaphylactic shock and death.

Drug allergens. An anamnesis in this direction must be collected very carefully, since this is not only a diagnosis of an allergic disease, but, first of all, it is the prevention of a possible death due to the unexpected development of anaphylactic shock. There is no need to convince that this type of allergy history should become a mandatory tool for all clinicians, since cases of anaphylactic shock and deaths with the introduction of novocaine, radiopaque substances, etc.

Because medications tend to be relatively simple chemical compounds, they act as haptens, combining with body proteins to form a complete antigen. In this regard, allergenicity medicinal substances depends on a number of conditions: 1) the ability of the drug or its metabolites to conjugate with protein; 2) the formation of a strong bond (conjugate) with the protein, resulting in the formation of a complete antigen. Very rarely, an unchanged drug can form a strong bond with a protein; more often this is due to metabolites formed as a result of the biotransformation of the drug. It is this circumstance that determines the fairly frequent cross-sensitization of medicinal substances. L.V. Luss (1999) provides the following data: penicillin cross-reacts with all drugs penicillin series, cephalosporins, sultamicillin, sodium nucleate, enzyme preparations, a number of food products (mushrooms, yeast and yeast-based products, kefir, kvass, champagne); sulfonamides cross-react with novocaine, ultracaine, anesthesin, antidiabetic agents (antidiabet, antibet, diabeton), triampur, para-aminobenzoic acid; analgin cross-reacts with salicylates and other non-steroidal anti-inflammatory drugs, food products, containing tartrazine, etc.

In this regard, another circumstance is important: the simultaneous administration of two or more drugs can mutually influence the metabolism of each of them, disrupting it. Impaired metabolism of drugs that do not have sensitizing properties can cause allergic reactions to them. L. Yeager (1990) makes the following observation: application antihistamines in some patients it caused an allergic reaction in the form of agranulocytosis. A careful analysis of these cases made it possible to establish that these patients were simultaneously taking medications that interfere with the metabolism of antihistamines. Thus, this is one of the compelling arguments against polypharmacy and a reason for clarifying the mutual influence on the metabolism of the drugs used in the allergy history. IN modern conditions To prevent allergic diseases, the doctor must know not only the names of drugs, indications and contraindications, but also know their pharmacodynamics and pharmacokinetics.

Quite often with the use medicines associated with the development of effects that A.D. Ado identified it as a separate group, which he called pseudo-allergy or false allergy. As has already been shown, the fundamental difference between pseudoallergy and allergy is the absence of preliminary sensitization associated with reagin antibodies (IgE). The clinical effects of pseudoallergy are based on the interaction chemical substances either directly with the membranes of mast cells and basophils, or with cell receptors for IgE, which ultimately leads to degranulation and release of biologically active substances, primarily histamine, with all the ensuing consequences.

It seems important to provide clinical guidelines to guide differential diagnosis drug allergies and pseudo-allergies. Pseudoallergy most often occurs in women after 40 years of age due to diseases that disrupt histamine metabolism or the sensitivity of receptors to biologically active substances (pathology of the liver and biliary tract, gastrointestinal tract, neuroendocrine system). The background for the development of pseudoallergy is also polypharmacy, oral use of drugs for ulcerative, erosive, hemorrhagic processes in the mucous membrane of the gastrointestinal tract; a dose of the drug that does not correspond to the age or weight of the patient, inadequate therapy for the current disease, changes in the pH environment and temperature of solutions administered parenterally, simultaneous administration of incompatible drugs (LussL.V., 1999). Characteristic clinical signs pseudo-allergies are: the development of the effect after the initial administration of the drug, the dependence of the severity of clinical manifestations on the dose and route of administration, the fairly frequent absence of clinical manifestations upon repeated administration of the same drug, the absence of eosinophilia.

At the end of the section on medicinal allergens there is a list medicines, which most often provoke the development of allergic diseases. In this list, which was compiled on the basis of data given in the works of L.V. Luss (1999) and T.N. Grishina (1998), the principle from most to least was used: analgin, penicillin, sulfonamides, ampicillin, naproxen, brufen, ampiox, aminoglycosides, novocaine, acetylsalicylic acid, lidocaine, multivitamins, radiocontrast agents, tetracyclines.

Chemical allergens. The mechanism of sensitization by chemical allergens is similar to drugs. Most often, allergic diseases are caused by the following chemical compounds: salts of nickel, chromium, cobalt, manganese, beryllium; ethylenediamine, rubber production products, chemical fibers, photoreagents, pesticides; detergents, varnishes, paints, cosmetics.

Bacterial allergens. The question of bacterial allergens arises in the so-called infectious-allergic pathology of the mucous membranes of the respiratory and gastrointestinal tract and, above all, in infectious-allergic bronchial asthma. Traditionally, bacterial allergens are divided into pathogen allergens infectious diseases and allergens of opportunistic bacteria. At the same time, according to V.N. Fedoseeva (1999), “there is a certain convention in the concepts of pathogenic and non-pathogenic microbes. The concept of pathogenicity should include more wide range properties, including the allergenic activity of the strain.” This is a very principled and correct position, since diseases in which the allergic component plays a leading role in pathogenesis are well known: tuberculosis, brucellosis, erysipelas, etc. This approach allows us to give specific meaning to the concept of opportunistic microbes that are inhabitants of mucous membranes (streptococci, neisseria , staphylococci, E. coli, etc.).

These microbes, under certain conditions ( genetic predisposition, immune, endocrine, regulatory, metabolic disorders; exposure to unfavorable environmental factors, etc.) can acquire allergenic properties and cause allergic diseases. In this regard, V.N. Fedoseeva (1999) emphasizes that “bacterial allergy plays a crucial role in the etiopathogenesis not only especially dangerous infections, but above all for focal respiratory diseases, pathologies of the gastrointestinal tract, and skin.”

Previously, bacterial allergy was associated with delayed-type hypersensitivity, since the high allergic activity of the nucleoprotein fractions of the microbial cell was established. However, back in the 40s. O. Swineford and J.J. Holman (1949) showed that polysaccharide fractions of microbes can cause typical IgE-dependent allergic reactions. Thus, bacterial allergies are characterized by a combination of delayed and immediate types of reactions, and this served as the basis for including specific immunotherapy (SIT) in the complex treatment of allergic diseases of a bacterial nature. Currently, there are “neuserial” bronchial asthma, “staphylococcal” infectious allergic rhinitis and etc. Practitioner should know that it is not enough to establish the infectious-allergic nature of the disease (for example, bronchial asthma); it is also necessary to decipher what type of opportunistic flora determines allergization. Only then, using this allergen vaccine as part of the SIT treatment, can a good therapeutic effect be obtained.

Currently, the significant role of dysbiosis in the formation of immunodeficiencies and immune failure has been established. From our point of view, dysbiosis of the mucous membranes is also one of the significant factors in the etioiatogenesis of allergic diseases. Clinicians should have in their hands not only a method for assessing intestinal dysbiosis, but also methods that allow them to assess the normality and dysbiosis of other mucous membranes, in particular the respiratory tract.

The most common etiopathogenetic factors of diseases of an infectious-allergic nature are: hemolytic and viridans streptococci, staphylococci, catarrhal micrococci, Escherichia coli, Pseudomonas aeruginosa, Proteus, and non-pathogenic Neisseria.

Collecting an allergic history begins with clarifying complaints from the patient or his parents, allergic diseases in the past, and concomitant allergic reactions. Important information can be obtained by identifying the child’s developmental characteristics before the onset of allergic manifestations, it is possible to detect sources of sensitization and factors contributing to its development. Often this is the mother’s excessive consumption of foods with high allergenic activity during pregnancy and breastfeeding, drug therapy mothers during this period and contact with aeroallergens in homes in high concentrations.

Exposure to these allergens after the birth of a child can also cause sensitization of the body.

Information about previous allergic reactions and diseases is essential, which most often indicates the atopic genesis of the developed allergic disease. If there are indications of allergic reactions and diseases in the past, the results of an allergological examination and the effectiveness of pharmacotherapy and specific immunotherapy in the past are clarified. Positive result antiallergic therapy indirectly confirms the allergic nature of the disease.

Particular attention is paid to the features of the development of the disease: the time and causes of the first episode of the disease, the frequency and causes of exacerbations, their seasonality or year-round occurrence are determined. Emergence allergic symptoms during the flowering season of plants indicates hay fever, and their year-round existence may be associated with sensitization to aeroallergens in homes. The connection between exacerbations of allergies and the time of day (day or night) is also being clarified.

Patients with hay fever feel worse during the daytime hours, when the concentration of pollen in the air is maximum. In children with tick-borne bronchial asthma and atopic dermatitis, the symptoms of the disease intensify in the evening and at night when in contact with bedding. Symptoms of allergic diseases caused by tick-borne sensitization ( bronchial asthma, allergic rhinitis, allergic conjunctivitis), appear more often in home environment, and when changing place of residence or hospitalization, the condition of patients improves. The well-being of such patients worsens when living in old wooden houses with stove heating and high humidity.

In children with diseases caused by sensitization to mold fungi (fungal bronchial asthma, fungal allergic rhinitis), exacerbation of the disease more often occurs when living in damp rooms, near water bodies, in forest areas with high humidity, upon contact with hay and rotten leaves. Living in rooms with a large amount of upholstered furniture, curtains, and carpets can increase sensitization to house dust allergens and can cause frequent exacerbations of respiratory and skin allergies.

The association of the occurrence of allergic symptoms with the consumption of certain foods indicates food sensitization. The manifestation of allergic manifestations upon contact with pets, birds, or when visiting a circus or zoo indirectly indicates sensitization to epidermal allergens. In cases of insect allergies, there is a connection between allergic manifestations and insect bites and contact with insects, for example, cockroaches. An allergy history can provide important information about drug intolerance.

In addition to information characterizing the participation of exogenous allergens in the development of allergic manifestations, anamnesis data allows one to judge the role of infection, pollutants, and nonspecific factors (climatic, weather, neuroendocrine, physical) in the development of allergic diseases.

Anamnesis data allows us to determine the severity of an allergic disease and differentiate anti-relapse therapy and preventive actions, determine the scope and methods of subsequent allergological examination to establish causally significant allergens.

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