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Related Experiment Videos

Difficult asthma: defining the problems.

S C Ranganathan1, D N Payne, A Jaffe

  • 1Royal London Hospital, London, UK.

Pediatric Pulmonology
|February 17, 2001
PubMed
Summary
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Difficult childhood asthma is often linked to adverse home environments, poor adherence, alternative diagnoses, and reduced corticosteroid responsiveness, not just higher inhaled corticosteroid doses.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Difficult-to-control asthma in children poses a significant clinical challenge.
  • High doses of inhaled corticosteroids (ICS) are often prescribed, raising concerns about side effects.
  • Understanding factors contributing to poor control is crucial for effective management.

Purpose of the Study:

  • To compare clinical and laboratory profiles of children with difficult asthma on high-dose ICS versus well-controlled children.
  • To identify key factors associated with poorly controlled asthma despite adequate inhaled corticosteroid therapy.

Main Methods:

  • Retrospective survey of children with difficult asthma (>= 800 microg ICS) and well-controlled asthmatic children.
  • Evaluated atopy, growth, lung function, treatment adherence, home environment, and corticosteroid responsiveness.

Related Experiment Videos

  • Compared characteristics between the poorly controlled and well-controlled groups.

    • Main Results:

    • Significant differences in home environment, with more smoking in the difficult-to-control group.
    • Nine children had alternative diagnoses, and 10 showed poor corticosteroid responsiveness.
    • Adverse home environments, poor supervision, alternative diagnoses, and CS unresponsiveness were key factors.

    Conclusions:

    • Difficult asthma in children is multifactorial, involving more than just ICS dosage.
    • Thorough assessment, including evaluation for alternative diagnoses and home environment factors, is essential.
    • Bronchoscopy may be indicated to guide treatment and avoid excessive corticosteroid use and potential side effects.