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Approach to the difficult pediatric asthmatic
1Capital Allergy and Respiratory Disease Center, Sacramento, CA 95819, USA.
Insights
Diagnosing infant wheezing requires evaluating lower airway anatomy and irritants. Management includes nonpharmacologic approaches like dietary changes and pharmacologic treatments such as inhaled corticosteroids.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Wheezing in infants and children poses diagnostic challenges.
- Evaluation requires understanding lower airway anatomy and potential irritants.
Purpose of the Study:
- To outline diagnostic and management strategies for pediatric wheezing.
- To differentiate between various causes of wheezing in children.
Main Methods:
- Review of factors influencing wheezing diagnosis.
- Analysis of nonpharmacologic and pharmacologic interventions.
Main Results:
- Differential diagnosis depends on symptoms and age.
- Nonpharmacologic management involves dietary protein sensitivity and environmental control.
- Pharmacologic treatment focuses on sodium cromoglycate and inhaled corticosteroids.
Conclusions:
- Comprehensive evaluation of lower airway anatomy and irritants is crucial.
- Integrated management strategies are essential for effective treatment of pediatric wheezing.
Abstract:
Wheezing in infants and children presents a difficult differential diagnosis contingent on the presenting symptoms and age of the child. A determination of the anatomy of the lower airway, combined with allergic, infectious, and noninfectious irritants, is requisite to a complete evaluation. The intervention strategies to decrease wheezing and bronchial hyperresponsiveness may include both nonpharmacologic and pharmacologic management. The nonpharmacologic management of asthma in children is contingent on aggressive treatment of dietary protein sensitivity and strict environmental control. The treatment of bronchial hyperresponsiveness with pharmacologic intervention in infants and children is relegated to the optimal use of sodium cromoglycate and inhaled corticosteroid.
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