Nonspecific adaptive reactions in outpatients of dermatovenereological profile

BACKGROUND: Changes in the morphological composition of the blood are among the most important criteria for diagnosing and predicting the course of diseases, allowing to assess the physiological state of the body. Calculated indices that can catch minimal changes in the indicators of the leukocyte blood formula in the early stages of the development of the pathological process make it possible to judge complex changes, sometimes imperceptible during the clinical examination of the patient. A well-known method characterizing the state of homeostasis is a method for assessing the state of homeostasis by adaptation reactions, which has been successfully used in patients with various pathologies.

AIMS: Study of the state of homeostasis of outpatients of the dermatovenereological profile to assess the severity of the disease and determine the tactics of their management and further treatment.

MATERIALS AND METHODS: Peripheral blood of 58 patients of dermatovenereological profile was examined. As a control ― peripheral blood of 24 practically healthy individuals. A complete blood test was performed on the device “ABX Micros ES 60” (France) with kits of the same company. The state of homeostasis was assessed according to adaptation reactions determined on the basis of the leukocyte blood formula by the method of L.H. Harkavy and E.B. Kvakina (1998). To increase the diagnostic value of the method, calculated integral hematological indicators were simultaneously used, characterizing the severity of the inflammatory process, intoxication, allergic reactions, and the state of the immune system.

RESULTS: In most outpatients of the dermatovenereological profile, physiological adaptation reactions prevail (90%, Z_58;0.05=6), represented mainly by reactions of high levels of adaptation ― reactions of increased and calm activation (77%, Z_40;0.05=12), which indicates a high functional activity of protective and adaptive mechanisms and the preservation of the constancy of homeostasis. In patients who made an outpatient appointment for problems from the urogenital tract, physiological adaptation reactions were observed more often (95%). At the same time, the physiological adaptation reactions in the majority (57%) of patients showed signs of tension, which indicates a violation of the harmony and functioning of the body’s subsystems and a decrease in the level of reactivity that require attention from the attending physician when prescribing treatment, choosing the appropriate drug and individually selecting doses. Signs of tension were more common (67%) observed in patients with a dermatological profile. Pathological reactions were observed in 6 (10%) patients and were represented by reactions of reactivation (4 patients), as well as reactions of acute (1 patient) and chronic (1 patient) stress. Among patients with pathological adaptation reactions, persons with skin diseases prevailed.

CONCLUSIONS: A comprehensive assessment of the state of homeostasis by adaptation reactions and calculated leukocyte indices significantly expands the diagnostic capabilities of a clinical blood test and allows assessing the course, severity of the inflammatory process and endogenous intoxication, the level of immunoreactivity of the body in outpatients of a dermatovenereological profile.