Evaluation of Children with Infantile Wheezing at The Age of Six: A New Asthma Predictive Index

Yıl 2019, Cilt: 2 Sayı: 2, 52 - 58, 06.12.2019

Ramazan Keçeci İsmail Reisli

Öz

Background: Recurrent wheezing is a common problem in young children. It is difficult to diagnose real asthma in children under 6 years of age because of different phenotypes of wheezing related disorders in this age group.
Patients and Method: This study was performed in the outpatient clinic of Pediatric Allergy and Immunology Department. This study includes 208 children who visited at least three times during the first three years of their lives with the complaints of wheezing attacks. Those who visited the department with the diseases such as congenital malformation, gastro esophageal reflux, tracheobronchial fistula, aspiration syndrome, heart failure, cystic fibrosis and immunodeficiency were eliminated and excluded from the study.
Findings: Transient early wheezing 107 (51,4%), non atopic wheezing 28 (13,5%), atopic wheezing 73 (35,1%) have been detected. Sixty five (31,3%) of the children were females and 143 (68,7%) were males. After the separate and together evaluation of the risk factors we have developed an asthma prediction index. The values of the index have been found as it is written below. The sensitivity 83%, specificity 90,7%, positive predictive value 89,2%, negative predictive value was 85,2%.
Conclusion: It might be possible to distinguish which of the children who comes to the department with the complaints of recurrent wheezing might suffer from asthma by using the asthma prediction index. It might also be possible to change the natural course of the disease by developing early intervene strategies

Anahtar Kelimeler

wheezing, child, wheezing phenotypes, asthma predictive index

Kaynakça

• 1. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med. 1995;332(3):133-8.
• 2. Hiat P. Recurrent or persistant lower respiratory tract symptoms. McMillan JA, DeAngelis CD, Feigin RD, Warshaw JB (eds): Oski's Pediatrics: Principles and Practice, 3rd edition, lippincott Williams and Wilkins, Philadelphia. 1999:1279-99.
• 3. Tenero L, Piazza M, Piacentini G. Recurrent wheezing in children Transl Pediatr 2016;5(1):31-36.
• 4. Samatha Sonnappa. Preschool wheeze: Phenotypes and Beyond. Pediatric Health. 2010; 4(3):267-75.
• 5. Taussig LM, Wright AL, Holberg CJ, Halonen M, Morgan WJ, Martinez FD. Tucson Children's Respiratory Study: 1980 to present. J Allergy Clin Immunol. 2003;111(4):661-75.
• 6. Stein RT, Martinez FD. Asthma phenotypes in childhood: lessons from an epidemiological approach. Paediatr Respir Rev. 2004;5(2):155-61.
• 7. Sears MR, Greene JM, Willan AR, Wiecek EM, Taylor DR, Flannery EM, et al. A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med. 2003;349(15):1414-22.
• 8. Morgan WJ, Stern DA, Sherrill DL, Guerra S, Holberg CJ, Guilbert TW, et al. Outcome of asthma and wheezing in the first 6 years of life: follow-up through adolescence. Am J Respir Crit Care Med. 2005;172(10):1253-8.
• 9. Bacharier LB, Beigelman A, Calatroni A, Jackson DJ, Gergen PJ, O'Connor GT, et al; NIAID sponsored Inner-City Asthma Consortium. Longitudinal Phenotypes of Respiratory Health in a High-Risk Urban Birth Cohort. Am J Respir Crit Care Med. 2019 Jan 1;199(1):71-82.
• 10. Xuan W, Marks GB, Toelle BG, Belousova E, Peat JK, Berry G, et al. Risk factors for onset and remission of atopy, wheeze, and airway hyperresponsiveness. Thorax. 2002;57(2):104-9.
• 11. Peat JK, Woolcock AJ. Sensitivity to common allergens: relation to respiratory symptoms and bronchial hyper-responsiveness in children from three different climatic areas of Australia. Clin Exp Allergy. 1991;21(5):573-81.
• 12. Kurukulaaratchy RJ, Matthews S, Arshad SH. Defining childhood atopic phenotypes to investigate the association of atopic sensitization with allergic disease. Allergy. 2005;60(10):1280-6.
• 13. Toelle BG, Xuan W, Peat JK, Marks GB. Childhood factors that predict asthma in young adulthood. Eur Respir J. 2004;23(1):66-70.
• 14. Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med. 1989;320(5):271-7.
• 15. Mirra V, Montella S, Santamaria F. Pediatric severe asthma: a case series report and perspectives on anti-IgE treatment. BMC Pediatr 2018; 18: 73.
• 16. Guilbert TW, Morgan WJ, Krawiec M, Lemanske RF Jr, Sorkness C, Szefler SJ, et al; Prevention of Early Asthma in Kids Study,Childhood Asthma Research and Education Network. The Prevention of Early Asthma in Kids study: design, rationale and methods for the Childhood Asthma Research and Education network. Control Clin Trials. 2004 Jun;25(3):286-310.
• 17. Razi CH, Harmancı K, Yılmaz G, Renda R, Okan Akın O. Tekrarlayan Hırıltılı Solunumu Olan Çocuklarda Atopi Sıklığı: Türkiye Çocuk Hastalıkları Dergisi 2009;3(4):10-15.
• 18. İnal A, GüneşerKendirli S, UfukAltıntaş D, Yılmaz M, BingölKarakoç G. Hışıltılı çocuklarda etiyoloji: Dört yıllık verilerimiz: Turkiye Çocuk Hast Derg 2009;3(1):24-30
• 19. Liu AH, Cover RA, Spahn JD, Sicherer SH. Childhood Astma. Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 20th ed. Philadephia: WB Saunders. 2015; 1095-116.
• 20. Devulapalli CS, Carlsen KC, Haland G et al.: Severity of obstructive airways disease by age 2 years predicts asthma at 10 years of age. Thorax. 2008 Jan;63(1):8-13.
• 21. Castro-Rodríguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1403-6.
• 22. Rusconi F, Galassi C, Corbo GM, Forastiere F, Biggeri A, Ciccone G, et al. Risk factors for early, persistent, and late-onset wheezing in young children. SIDRIA Collaborative Group. Am J Respir Crit Care Med. 1999;160:1617-22.
• 23. L. F. A. De Swert. Risk factors for allergy. Eur J Pediatr 1999;158:89-94.
• 24. Litonjua AA, Carey VJ, Burge HA, Weiss ST, Gold DR. Parental history and the risk for childhood asthma. Does mother confer more risk than father? Am J Respir Crit Care Med 1998;158:176-81.