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Published on: November 4, 2010
[Asthma and the child below 5 years of age: diagnosis and treatment]
L L Clainche1, S Timsit, V Rigourd
1Service de Pneumo-allergologie pédiatrique, Hôpital Necker-Enfants Malades, Paris.
Insights
Pediatric asthma, a growing public health concern, requires early diagnosis for effective treatment. Prompt intervention prevents irreversible lung damage and supports healthy pulmonary development in children.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Public Health
Context:
- Asthma is the most common chronic pediatric disease, with increasing prevalence posing a significant public health challenge.
- Diagnosing asthma in young children is challenging, often presenting after viral infections and requiring a diagnosis of exclusion.
- Delayed or inadequate asthma management can lead to irreversible airway remodeling and compromise lung growth and reserve.
Purpose:
- To highlight the importance of early asthma diagnosis in children.
- To emphasize the role of inhaled therapies and appropriate treatment, including inhaled corticosteroids, in managing severe pediatric asthma.
- To underscore the need for a comprehensive approach to asthma management, addressing environmental factors and patient education.
Summary:
- Early diagnosis and treatment of pediatric asthma are crucial to prevent irreversible airway remodeling and preserve lung function.
- Inhaled therapies, including spacer devices and nebulizers, facilitate treatment in young children, with inhaled corticosteroids vital for severe cases.
- Comprehensive asthma management extends beyond medication to include reducing viral infections, domestic pollution, and allergen exposure, alongside robust patient education and support.
Impact:
- Facilitates timely intervention, potentially preventing long-term respiratory complications and improving quality of life for children with asthma.
- Informs healthcare providers about the nuances of pediatric asthma diagnosis and the benefits of early, targeted therapeutic strategies.
- Underscores the critical role of environmental control and adherence support in optimizing asthma outcomes in pediatric populations.
Abstract:
Asthma is the most frequent chronic disease in pediatrics and the increase in its prevalence is a major public health problem. Diagnosis may be difficult in the young child, symptomatology most often occurring following a viral infection. It is important not to ignore a foreign body in the airways or fibrocystic disease and asthma remains, particularly in infants, a diagnosis of elimination. Misdiagnosis or insufficient treatment of asthma may risk the development of irreversible histological lesions and also could compromise pulmonary growth and the child's lung reserve. Spacer devices and nebulisers enable inhaled therapy to be administered to very young children. The value of early diagnosis is to institute appropriate treatment notably in severe asthma with inhaled corticosteroid therapy, the aim being to reduce remodelling lesions of the airways. The minimal effective dose should be defined to minimalise side-effects. The treatment of asthma is not restricted to pharmacotherapy: attempts should be made to reduce intercurrent viral infections, domestic pollution (including smoking) and allergenic concentrations. However, as for all chronic diseases, the clinician will encounter poor compliance. The work of education and support of health professionals is fundamental to the management of asthma.
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