Natural history of asthma in children

Asthma is a syndrome of reversible bronchial obstruction in hyperresponsive airways mediated by allergy or other trigger factors. Allergic disease represents true asthma while transient wheezing may be caused by factors such as viral infection, aspiration, prematurity and neonatal lung damage and is likely to outgrow within few years. Personal or family history of atopy, increased serum IgE and positive skin tests may suggest allergic asthma, which persists throughout life irrespective of presence or absence of symptoms. Onset of age beyond 2 years, severity, persistence or recurrence of symptoms beyond 6 years of age, airway hyperresponsiveness and abnormal lung function even in absence of symptoms, strong family history especially in the mother, exposure to allergens, parental smoking and delay in starting appropriate therapy are some of high risk factors in persistence of asthma in adult life. As outcome of asthma depend upon multiple variable factors, it is difficult to predict natural history of asthma in an individual child.