Abstract
4000 cases of childhood asthma attending our ambulatory clinic for the first time before December 31, 1981, were examined. 46 children were selected: they all had to have an actual age >15 years and at least 3 physiologic evaluations of pulmonary function performed before 10 years of age, in interval phases, that is between episodes, of their illness and in a period > 6 months. On the ground of this specific selection, we defined “persistent a thma” the cases who had a persistent residual alteration of forced expiratory volumes (FEV1 <85% and FEF 25-75 < 80% of the “expected values”)verified at least for 3 times in “interval phases”(asymptonatic before 10 years of age. 39 subjects were entered into the study:13 (gp.A) were asymptomatic by tl of puberty;26 (gp.B). on the contrary, had had at least an asthmatic attack in an age > 13 years. Age a onset of asthma (gp.A:2,9 yearsvs, gp.B:3.2 years) did not affect the prognosis, nor sex of the patten family history of atopic diseases (gp.A:60% vs.gp.B:55%)or asthma (gp.A:31% vs.gp.B:46%). Immunoterapy for a period ≥ 3 years had been performed in 70% cases of gp.A and in 85% cases of gp.B. Similarly th was no significant difference between the two groups with regard to the IgE levels in the serum and the generic prick test positivity (100% positive in both groupsjor to the positivity to specific all gens (foods, pollens, H.D.H). Furthermore frequency and gravity of the asthmatic attacksat the age < 10 years did not differ between gp.A vs.gp.B. The 2 groups showed a significant difference In terms of a tual pulmonary functions:an abnormal FEF 25-75 was registered in only 2 patients of gp.A and in 20 of gp.B (15% vi.77%:p <0.001), (p<0.01 for FEV1 values). The presence of assuctated persistent eczema (ov r the first 2 years of age)was associated significantly to the gp.B (p<0.05), while the long tern breas feeding (>3months)clearly improved the long term prognosis (gp.A:70% vs. gp.B:35%)but values were nearly significant. An highly significant difference between the two groups was found for the spirometric “-terationes proved < 10 years (p* 0.002):70% of patients of gp.B could be designed as having “persist nt asthma” in that age, vs.15% of patients of gp.A.when assumed FEV, and (particularly) FEF 25-75 assessed at the age 7-10 years in the “interval phases” of the illness the best “marker” of our 2 groups(A vs.B) evaluated the prognostic value of this parameter:only 10% of the cases who < 10 years of age showed riationes in their airflow obstruction without ever reverting to normal lung function (persistent < “grow ouf” of their illness after puberty (spirometric and clinical recovery). On the other hand only of the cases who before 10 years showed “intermittent asthma” had not remission after puberty.
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Longo, G., Poli, F., Strinati, R. et al. PREDICTING THE COURSE OF ASTHMA IN CHILDREN. Pediatr Res 22, 223 (1987). https://doi.org/10.1203/00006450-198708000-00061
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DOI: https://doi.org/10.1203/00006450-198708000-00061