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[Asthma in infants and young children: definitions and epidemiology]
1Service d'allergologie et de pneumologie, hôpital des Enfants, 330, avenue de Grande-Bretagne, BP 3119, 31026 Toulouse, France. guy.dutau@wanadoo.fr
Insights
Pediatric asthma is a syndrome, not a disease, with most infants not developing persistent allergic asthma. Careful evaluation is crucial to distinguish true asthma from other conditions in wheezy children.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Context:
- Infant and young child asthma (under school age) is recognized as a syndrome, not a distinct disease.
- Existing definitions from 1981 remain relevant, but recent epidemiological data reveal diverse clinical scenarios.
Purpose:
- To differentiate between transient wheezing syndromes and persistent asthma in young children.
- To highlight the importance of accurate diagnosis for appropriate management and prognosis.
Summary:
- Less than 20% of infants diagnosed with asthma have allergic asthma that persists beyond age 10.
- Respiratory syncytial virus (RSV) bronchiolitis is a common cause of childhood asthma, but pre-existing airway abnormalities can complicate interpretation of sequelae.
- Prospective follow-up of newborn cohorts and thorough examination of wheezy children are essential to exclude "false asthma" and identify "true asthma".
Impact:
- Improved diagnostic accuracy for pediatric asthma.
- Better understanding of asthma phenotypes in early childhood.
- Informed clinical management strategies for wheezy infants and young children.
Abstract:
Asthma of infants and young children (under school age) is a syndrome and not a disease. While the definitions given in 1981 by Tabachnik an Levision and by Geubelle still hold good, recent epidemiological findings show that several situations exist. Less than 20% of asthmatic infants in fact have allergic asthma that will persist after the age of 10. Bronchiolitis due to respiratory syncytial virus leads to a common variety of asthma. But pre-existing abnormalities of the small airways which create favorable conditions for bronchiolitis may also lead us to overestimate the sequelae. Prospective follow-up of cohorts of newborns is thus very important, and all wheezy children should undergo careful examination to exclude "false asthma" and identify "true asthma".