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[Bronchiolitis and persistent wheezing. Is eosinophilia a risk factor?]
C Calvo Rey1, M García García, M Albañil Ballesteros
1Servicio de Pediatría, Hospital Severo Ochoa, Madrid, Spain. ccalvo@mi.madritel.es
Insights
Infant bronchiolitis with high eosinophil counts (> 1%) increases the risk of persistent wheezing. Familial asthma history is linked to long-term wheezing, highlighting key risk factors for early respiratory issues.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Context:
- Bronchiolitis is a common viral respiratory infection in infants.
- Persistent wheezing post-bronchiolitis can impact long-term respiratory health.
- Identifying early risk factors is crucial for predicting asthma development.
Purpose:
- To determine the long-term outcomes of infant bronchiolitis.
- To analyze risk factors for persistent wheezing, focusing on eosinophilia.
- To investigate the association between eosinophil levels and wheezing persistence.
Summary:
- A study of 170 infants hospitalized for bronchiolitis found that 66.5% developed short-term and 35.3% long-term persistent wheezing.
- Elevated eosinophil counts (> 1%) during acute bronchiolitis were significantly associated with short-term persistent wheezing.
- A family history of asthma correlated with the development of long-term persistent wheezing.
Impact:
- Eosinophil levels during infant bronchiolitis serve as a predictive marker for persistent wheezing.
- Findings aid in early identification and management strategies for children at risk of asthma.
- Understanding these risk factors can inform clinical practice and public health initiatives.
Objectives:
To investigate the final outcome of infants presenting an episode of bronchiolitis and to analyze the risk factors for the development of persistent wheezing, with special attention paid to the presence of eosinophilia during the acute episode.
Patients And Methods:
We studied all the children aged less than 2 years who required hospitalization for bronchiolitis between 1990 and 1993. Eosinophil values during the acute phase were collected. Clinical evolution and outcome were classified in three groups: short-term persistent wheezing (if resolved before the child reached the age of 5 years), long-term persistent wheezing (if the child remained symptomatic after the age of 5 years) and no wheezing. Other risk factors for asthma such as familial history, passive smoking and respiratory syncytial virus isolation were also studied.
Results:
We analyzed 170 patients (100 boys and 70 girls) aged 7.15 6 0.78 years who suffered an episode of acute bronchiolitis at the age of 5.4 4.2 months. One hundred thirteen patients (66.5 %) developed short-term persistent wheezing and 60 (35.3 %) developed long-term persistent wheezing. Fifty-six patients presented no wheezing. The number of patients with eosinophils > 1 % was significantly different in the three groups of patients (p 5 0.029). A Eosinophil values of > 1 % was associated with short-term persistent wheezing (p 5 0.013). Mean eosinophil values were higher in patients who developed wheezing at some time during evolution (p 0.028). A familial history of asthma was associated with the development of long-term persistent wheezing (p 0.033).
Conclusions:
In the population studied, eosinophil values of > 1 % during an episode of acute bronchiolitis in infancy was associated with a higher risk of developing persistent wheezing in the first 5 years of life. A familial history of asthma was associated with a higher risk of developing long-term persistent wheezing.