Comprehensive assessment of the health status of early-age children with undifferentiated connective tissue dysplasia signs

The ontogenetic affinity of connective tissue components with cells of the immune system predetermines the development of infectious, autoimmune, and allergic syndromes in patients with undifferentiated connective tissue dysplasia (UCTD). The relevance of today is to study the peculiarities of the morbidity of infants and early-age children who had locomotor and biochemical signs of UCTD in the neonatal period. Aim - to investigate the correlation between the markers of UCTD in newborns and clinical manifestations of UCTD, as well as the peculiarities of morbidity in them at the age of 1-36 months. Materials and methods. At the first research stage, anthropometric and biochemical (matrix metalloproteinase-1 (MMP-1), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1)) markers of UCTD had been studied in 122 newborns. At the second stage, 49 children from among those examined in the neonatal period up to the age of 36 months were subjected to follow-up observation. Phenotypic (external) and visceral (cardiac) signs of UCTD, as well as infectious, allergic, and autoimmune morbidity had been investigated by questionnaire survey and clinical examination. The main group (n=31) included children with neonatal anthropometric markers of UCTD, the control group (n=18) included children without signs of UCTD. Results. In children with neonatal markers of UCTD at the age of 36 months, a combination of multiple phenotypic and cardiac signs of UCTD was diagnosed. A higher morbidity of iron deficiency anemia (IDA), food allergies, asthma, atopic dermatitis, allergic rhinitis, juvenile idiopathic arthritis (JIA) was determined in children against the background of UCTD. The children of the main research group had more episodes of acute respiratory infections (ARI) and acute intestinal infections (AII) during the year. The presence of UCTD was associated with the morbidity of infectious mononucleosis (IM) and acute RSV-bronchiolitis. It was found that neonatal MMP-1 activity and MMP-1/TIMP-1 index correlated with the morbidity of IDA, JIA, allergic diseases, ARI, AII, IM, RSV-bronchiolitis in children aged 1-36 months. Conclusions. The children with neonatal markers of UCTD at the age of 36 months have a combination of multiple clinical signs of this disease. UCTD is a prognostically unfavorable factor for infectious morbidity, development of autoimmune and allergiс diseases, and formation of comorbid and associated somatic pathology in early-age children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. For each child, the informed consent of its mother to participate in the study was obtained. The authors declare no conflict of interest.