Immune-Related Problems

Children sometimes present (as early a few months) with recurrent infection, usually the upper and lower airways, but could also present with recurrent urinary tract, skin or gut infections. The children also require frequent treatment with antibiotics which further compromises the immune system by destabilizing the gut flora. This deranges the normal immune response of the body to infections.

The general approach would be to avoid conditions of bacterial and viral overexposure. This is often unrealistic as children have to attend school or be managed in a care centre.

In addition it would be prudent to minimise exposure to allergies and support the patient with allergies with immune system ‘boosters’ e.g. natural products or more sophisticated pharmaceuticals. 

In more complex cases, it is often required to perform blood tests in order to quantify the exact immune deficiency whereby a more directed immune support can be instituted.   

Allergies

The Western Cape is notorious for the high pollen load, resulting in children suffering from allergy-related problems, e. g. asthma, recurrent bronchitis, eczema and allergic nasal symptoms. 

The general approach would normally be to avoid the offending agents, which in this case is virtually impossible. Therefore it is important to manage the acute exacerbation as quickly as possible aiming to prevent secondary bacterial infections and stabilise the overactive and abnormal primed immune system. 

A combination of antihistamines, mucolytics and in some cases steroids, in various combinations, should normally be successful to support the patient. 

Neurological Problems

Children often suffer from an array of problems related to the nervous system, either the result of a genetic disorder or due to an insult to the brain (during pregnancy or birth, near-drowning, accidents or to infections (meningitis or encephalitis)). 

These children usually present with damage to the neurological system due to lack of oxygen, abnormal development of the brain (as in Down syndrome) or with deranged neurotransmitters such as in attention deficit disorder, autism and Tourette syndrome. 

The approach will be to ascertain the cause of neurological damage by performing a number of tests and evaluation by psychologist, occupational therapist, remedial teachers or doctors. Once the diagnosis has been confirmed certain support measures can be instituted.

In cases such as concentration, anxiety or behavioural problems, a number of medications have been tested and trialed and by optimising the medication for a specific child, it will often lead to a dramatic improvement.