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[Asthma phenotype during the first six years of life]
D M Ocampo Martínez1, J Gómez Vera, G Flores Sandoval
1Servicio de Inmunología Clínica y Alergia, Hospital Regional Lic, Adolfo López Mateos, ISSSTE, México, DF.
Insights
Pediatric asthma often presents as persistent wheezing after age three, linked to allergies. Gastroesophageal reflux is also a common finding in young children with asthma.
Area of Science:
- Pediatric respiratory medicine
- Allergology
- Gastroenterology
Context:
- Asthma is a leading cause of wheezing in early childhood.
- Limited research exists on early-life asthma phenotypes.
- Understanding these phenotypes is crucial for effective management.
Purpose:
- To characterize the asthma phenotype in children under six years old.
- To investigate the association between allergic sensitization and asthma in this age group.
- To explore the role of gastroesophageal reflux in pediatric asthma.
Summary:
- A study of 185 children under six with a history of recurrent wheezing identified key asthma phenotypes.
- The most common phenotype involved persistent wheezing beyond three years, strongly associated with an allergic component.
- Significant correlations were found between atopy, positive skin tests, eosinophilia, and elevated immunoglobulin E (IgE).
- Gastroesophageal reflux was identified in 44% of patients and significantly correlated with positive skin tests.
Impact:
- Identifies a prevalent asthma phenotype in young children characterized by allergic sensitization and persistent wheezing.
- Highlights the significant comorbidity of gastroesophageal reflux in pediatric asthma.
- Provides valuable data for refining diagnostic and therapeutic strategies for early-onset asthma.
Unlabelled:
Asthma is one of the main wheezing causes during the first years of life. In our country it is a common respiratory chronic illness but insufficient studies still exist on the asthma phenotypes during the first years of life.
Objective:
To know the phenotype of asthma in a group of children younger than 6 years old.
Material And Methods:
185 children of both sexes were studied with antecedent of having presented wheezing (tree episodes or more) and it registered data about the antecedents of family and personal allergy, dietary habits during the first year of life, infections, data on the beginning and the evolution of the condition, and they were practiced determinations of peripheral eosinophilia, total serum IgE and gastric gammagram to discard illness for gastroesophageal reflux. All were carried out skin tests for foods and aeroallergens.
Results:
In the group of 185 patients of both sexes, they had data that supported the allergic process, in 137. It was correlated the atopy antecedents significantly, positive skin tests, eosinophilia (more than 300), with elevated IgE for the age (p < 0.05). The gastric gamagrama was carried out in 144 patients, of which were positive results for gastroesophageal reflux in 64 (44%) and in 79 (54%) it was reported doubtful or negative. It was related the gastroesophageal reflux presence and the positive skin tests significantly (p < 0.05).
Conclusions:
The more common phenotype of asthma in our patients corresponds to a wheezing pattern that persist after the 3 years old, in relation to an allergic component. Furthermore in most of those children a positive gastroesophageal reflux was an important finding.